冠状动脉旁路移植术117例分析  

Coronary artery bypass grafting in 117 patients

作　　者：孟磊[1] 刘志勇[2] 张开广[1] 赵德佑[1] 胡正群[1] 俞辉[1] 

机构地区：[1]东南大学医学院附属徐州医院胸心外科,江苏徐州221009 [2]东南大学附属中大医院胸心外科,江苏南京210009

出　　处：《现代医学》2003年第6期379-381,共3页Modern Medical Journal

摘　　要：目的　总结冠状动脉旁路移植术治疗冠心病的经验并探讨影响疗效的相关因素。方法　 117例患者中男92例 ,女 2 5例 ;年龄 3 8～ 78岁 ,平均 64 .5岁 ;3支血管病变 79例 ,2支病变 3 1例 ,单支病变 7例 ;左主干病变 15例 ;曾行支架术者 12例。体外循环下行冠状动脉旁路移植术 75例 ,非体外循环下 42例。均经胸骨正中切口 ,平均搭桥 3 .1支 ( 1～ 6支 )。心肌保护采用冷血含钾停搏液。体外循环时间 ( 12 0± 3 1)min ,主动脉阻断时间 ( 75± 2 7)min。非体外循环搭桥手术时间 ( 15 8± 2 6)min。结果　死亡 2例。随访中除 4例出现心绞痛症状、需服抗心绞痛药物治疗外 ,其余心绞痛症状均消失 ,心功能显著改善 ,生活质量明显提高。结论　冠状动脉旁路移植术是治疗冠心病的有效方法 ,严格掌握手术适应证 。Objective To summarize the experience of coronary artery bypass grafting (CABG) in the treatment of coronary artery disease.Methods One hundred and seventeen (92 men,25 women) patients with coronary artery disease underwent CABG.Seventy-nine patients had triple-vessel diseases,31 double-vessel diseases,7 single-vessel diseases and 15 main artery lesion.Coronary stents had been implanted in 12 cases. The mean age of the patients was 64.5 years(38～78 years).Sevety-five patients were performed on hypothermia cardiopulmonary bypass (CPB) and 42 on beating heart.Myocardial preservation was carried out by cold blood cardioplegia with potassium.All patients received CABG through median sternotomy.An average 3.1 grafts(1～6) were performed in operation.The mean duration of CPB time was(20±31) min and that of aortic-cross clamping was (75±27) min.The average time of off-pump CABG was (158±26) min.Results Two patients died during hospitalization.The angina pectoris recurred in 4 patients and anti-angina medicine was needed in the postoperative follow-up.Cardiac function of the other patients was improved.The quality of life was remarkably improved.Conclusions CABG is a safe and effective way for the treatment of coronary heart disease.Strict mastery of surgery indications and perfect perioperative management are pivotal factors of CABG.

关 键 词：冠状动脉旁路移植术 手术治疗 冠心病 影响因素 体外循环 

分 类 号：R654.2[医药卫生—外科学]