摘要
目的分析非体外循环与体外循环下冠状动脉旁路移植术(CABG)对患者中期预后的影响。方法收集空军军医大学第一附属医院心血管外科收集行开胸CABG且符合纳入与排除标准的118例患者,按是否行体外循环分为A组(体外循环下CABG,n=53)与B组(非体外循环下CABG,n=65),比较两组手术情况(手术时间、搭桥数目、术中出血量、输血量、ICU时间、气管插管时间、总住院时间及早期并发症发生率),统计随访5年生存情况及主要不良心脑血管事件发生情况。结果B组手术时间、总住院时间为(196.52±30.61)min、(13.36±4.34)d,短于A组的(287.98±42.27)min、(18.14±5.16)d(t=13.612、5.465,P均<0.05);术中出血量、输血量为(513.63±31.74)ml、(426.74±40.96)ml,少于A组的(721.41±47.63)ml、(808.52±50.79)ml(t=28.308、45.208,P均<0.05);术后早期总并发症发生率为12.31%,低于A组的28.30%(χ^(2)=4.759,P=0.029)。A组随访中位生存时间为51.76个月(95CI:47.871~55.678),B组为55.84个月(95%CI:52.945~58.743),差异无统计学意义(P=0.219)。结论非体外循环下CABG较体外循环CABG可缩短手术时间,减少术中出血量,降低术后早期并发症发生率,缩短患者术后恢复时间,但两者术后中期预后相似。
Objective To analyze the effects of off-pump and on-pump coronary artery bypass grafting on medium-term prognosis of the patients.Methods A total of 118 patients who met the inclusion and exclusion criteria underwent thoracotomy and coronary artery bypass grafting at the First Affiliated Hospital of Air Force Military Medical University.According to whether extracorporeal circulation was performed or not,they were divided into group A(on-pump coronary artery bypass grafting,n=53)and group B(off-pump coronary artery bypass grafting,n=65).Conditions of operation(operation time,number of grafts,intraoperative blood loss,blood transfusion volume,length of intensive care unit stay,tracheal intubation time,total length of hospital stay and the incidence of early complications)were compared between the two groups.The survival status and the incidence of major adverse cardiovascular and cerebrovascular events at 5 years of follow-up were statistically analyzed.Results The operation time and total hospital stay of group B[(196.52±30.61)min and(13.36±4.34)d]was shorter than that of group A[(287.98±42.27)min and(18.14±5.16)d](t=13.612,5.465,both P<0.05).The intraoperative blood loss and blood transfusion volume[(513.63±31.74)ml and(426.74±40.96)ml]were less than group A[(721.41±47.63)ml and(808.52±50.79)ml](t=28.308,45.208,both P<0.05).The incidence of early postoperative complications in group B(12.31%)was lower than group A(28.30%)(χ^(2)=4.759,P=0.029).The median survival time of group A and group B was 51.76 months(95CI:47.871-55.678)and 55.84 months(95%CI:52.945-58.743),without statistically significant difference between the groups(P=0.219).Conclusion Compared with on-pump coronary artery bypass grafting,off-pump coronary artery bypass grafting can shorten the operation time,reduce intraoperative blood loss,lower the rate of early postoperative complications,and shorten the postoperative recovery time.However,of them have a similar mid-term postoperative prognosis.
作者
樊苗
翟蒙恩
罗恒
吕向妮
Fan Miao;Zhai Meng’en;Luo Heng;Lv Xiangni(Cardiovascular Surgery,Operating Theatre,the First Affiliated Hospital of Air Force Military Medical University,Shaanxi Xi'an 710032,China)
出处
《中国体外循环杂志》
2023年第5期272-276,共5页
Chinese Journal of Extracorporeal Circulation
基金
国家自然科学基金青年科学基金项目,编号82000373
