冠状动脉旁路术中不同旁路材料的应用体会  

Experience of the application of different conduits for coronary artery bypass grafting surgery

作　　者：程兆云[1] 张志东[1] 高传玉[1] 高恩民[1] 李俊秀[1] 孟凡民[1] 张立[1] 黄建民[1] 陈莎莉[1] 宋芳[1] 

机构地区：[1]河南省人民医院,郑州市450003

出　　处：《河南诊断与治疗杂志》2003年第1期2-4,共3页Henan Journal of Diagnosis and Therapy

摘　　要：目的 :总结冠状动脉旁路移植术中目前几种常用旁路材料的临床应用。方法 :2 0 0 0年 1月～ 2 0 0 2年 3月连续 5 6例行冠状动脉旁路移植术 ,旁路材料包括左乳内动脉 (5 6根 )、游离右乳内动脉 (2 1根 )、桡动脉 (3 2根 )和大隐静脉(4 3根 )。回顾分析不同旁路材料的手术结果。结果 :桡动脉移植后旁路血管“线样征”1例 ;无胸骨、前臂并发症 ;下肢切口感染 2例 ,均为糖尿病、大体重患者 ,治疗后痊愈 ;死亡 3例 ,与旁路材料无关 (非体外循环手术因循环状态不稳死亡 1例 ,鱼精蛋白过敏 1例 ,顽固性心律失常 1例 )。结论 :注意旁路材料的取制技巧 ,针对不同病变冠脉血管选取应用不同旁路血管 。Objective To review the clinical experience of the application of different conduits for coronary artery bypass grafting surgery.Methods A total of 56 cases of coronary artery bypass grafting were performed from January 2000 to March 2002.Conduits used included 56 left internal mammary arteries,21 free right internal mammary arteries,32 radial arteries and 43 saphenous veins.The operative results were respectively analysed.Results A string sign was noted on the angiogram of a patient with radial artery.No complications occurred in the sternum and the forearm.Two diabetic overweighted patients had wound infection in the lower legs.There were 3 postoperative deaths,no relating to the conduits.One death was due to unstable hemodynamics during the off-pump coronary bypass procedure.The second death was caused by the allergy to protamine.Refractory arrhythmia attributed to the third death.Conclusion The harvesting technique,use of proper conduits to different target vessels and good postoperative monitoring and management are the keys to the satisfactory results.

关 键 词：冠心病 冠状动脉旁路移植术 旁路材料 CABG 

分 类 号：R654.2[医药卫生—外科学] R318.1[医药卫生—临床医学]