非体外循环辅助下冠状动脉旁路移植术术后处理  

Postoperative treatment of off-pump coronary artery bypasss grafting

作　　者：李一粟[1] 马建珍[1] 张红超[1] 于鲁峰[1] 秦斌[1] 仲京[1] 陈元恒[1] 徐金星[1] 张立莉[1] 魏贤珍[1] 王维新[1] 万士杰[1] 

机构地区：[1]空军总医院心外科,北京100036

出　　处：《空军总医院学报》2004年第1期21-22,共2页Journal of General Hospital of Air Force,PLA

摘　　要：目的 总结32例非体外循环辅助下冠状动脉旁路移植术(Off-pump coronary artery bypasss grafting,OPCAB)术后处理的临床经验,并对其进行初步探讨。 方法 2000年12月-2003年11月我们共完成OPCAB 32例,其中2支病变5例,3支病变15例,4支病变9例,5支病变3例。采用乳内动脉、桡动脉和/或大隐静脉共移植血管99支,平均每例3.1支。 结果 无手术死亡,无围手术期心肌梗死等严重并发症发生。平均术后辅助呼吸时间10±2.5小时,平均ICU监护治疗时间72小时,术后早期发生心律失常12例,术后切口感染5例,胸骨骨不连2例。术后平均住院17.6±4.5天。术后短期随访显示临床效果满意。 结论 OPCAB可作为冠状动脉旁路移植的手术方法之一,术后早期适时尽早拔出气管内插管,调整血容量,水、电解质平衡,预防和及时处理心律失常等并发症是术后早期处理的关键。Objective To review the clinical experience of postoperative treatment of coronary artery bypass grafting without the assistance of extracorporeal cireulation(Off-pumpCABG, OPCAB). Methods Between december 2000 and november 2003, 32 consecutive OPCAB were performed at our hospital. Results There was no mortality, no perioperative myocardial infarction. There was no major postoperative complications. Short-term follow-up shows the outcomes were satisfactory. Conclusion OPCAB may be considered as an alternative procedure for coronary artery bypass grafting. However, it is techniqually more demanding and its postoperative treatment is also very important.

关 键 词：非体外循环 冠状动脉旁路移植术 术后处理 急性心肌梗死 心绞痛 

分 类 号：R654.2[医药卫生—外科学]