大隐静脉和上臂头静脉移植对70岁以上病人心肌血管重建作用的比较  

Comparison of saphenous vein and cephalic vein graft patency in patients older than 70 years

作　　者：司忠义[1] Klinge U 谷春久[3] 

机构地区：[1]锦州医学院附属第一医院心脏外科,辽宁锦州121001 [2]德国亚琛科技大学医学院外科,德国亚琛52074 [3]中国医科大学附属第一医院心脏外科,辽宁沈阳110001

出　　处：《中国心血管杂志》2004年第3期172-174,共3页Chinese Journal of Cardiovascular Medicine

摘　　要：目的　冠状动脉旁路移植术是治疗缺血性心脏病一种常规方法 ,但是由于所采用的移植血管不同 ,导致治疗的效果也不尽相同。目前治疗常用的血管为大隐静脉 +乳内动脉为标准手术术式。然而诸多原因限制 ,有时大隐静脉不适合作为移植材料。本研究对大隐静脉与上臂头静脉作为移植材料进行比较。方法　接受乳内动脉和大隐静脉旁路移植术组 35例 ,平均年龄 77岁 ,接受乳内动脉 +上臂头静脉旁路移植术组 15例 ,平均年龄 75岁 ,二组之间 ,体重 ,心肌梗死病史 ,心功能 ,平均每例冠状动脉病变以及平均移植血管数没有明显差别。结果　乳内动脉和大隐静脉旁路移植术组和乳内动脉 +上臂头静脉旁路移植术组之间 ,乳内动脉的五年累计通畅率分别为 96 %和94 % ,二组之间没有显著性差异 (P>0 .0 5 ) ,大隐静脉的通畅率为 70 % ,上臂头静脉为 4 8% ,二组之间差异性不明显 (P>0 .0 5 )。结论　通过两组间的 5年累计通畅率的比较 ,我们认为在高龄病人上臂头静脉作为移植血管效果差 ,术后通畅率低 ,但可以作为移植血管的最后选择。Objective To compare the patency of two methods of coronary artery bypass grafting (CABG) in patients over 70 years . Methods Group I (ITA+Saphenous vein) patients (n=35, average years 77) accepted; Group II (ITA+ Cephalic vein) patients (n=15, average years 75) accepted internal thoracic artery (ITA) and cephalic vein as grafts. Both groups accepted operations in 1995. Results There were no difference regarding age, gender, left ventricular ejection fraction or incidence of three vessel diseases between group I and group II. The five year cumulative patency of ITA was 96% and 94% in group I and II respectively, but the five year cumulative patency of vein graft was 70% in group I and 48% in group II, however there was no statistic difference (P>0.05). Conclusions Although there is no statistic difference in the vein grafts between group I and group II, but we believe that cephalic vein grafts have disappointed patency in advanced patients, it can be the last election as graft.

关 键 词：冠状动脉旁路移植术 大隐静脉 上臂头静脉 通畅率 

分 类 号：R654.2[医药卫生—外科学]