摘要
目的评估非体外循环动脉化冠状动脉旁路移植术(AOPCAB)与常规体外循环下冠状动脉旁路移植术(CCABG)相比是否具有优越性。方法将60例2支以上血管病变行冠状动脉旁路移植术(不包括瓣膜手术或室壁瘤切除等合并手术的病例)患者分为AOPCAB组和CCABG组,40例AOPCAB组通过胸骨正中切口,在非体外循环心脏不停跳下完成冠状动脉旁路移植术;20例CCABG组建立常规体外循环,心脏停搏下完成冠状动脉旁路移植术。对两组病例的术前和术后各项指标进行对比分析。结果两组患者术前的一般情况无差异,AOPCAB组与CCABG组移植旁路血管分别为2.9±0.8支比3.9±1.1支(P<0.01),但所用的血管材料两组间无差异。AOPCAB组术后呼吸机辅助时间和外科住院时间较短,住院费用较低(P<0.05)。AOPCAB组无手术死亡,CCABG组死亡1例(P>0.05)。结论 AOPCAB治疗冠心病多支病变的初期结果显示可以减少患者术后辅助呼吸时间和外科住院时间,降低住院费用,术后并发症少,但远期效果仍有待进一步临床研究验证。
Objective To test whether off-pump coronary artery bypass grafting (AOPCAB) has advantages over conventional coronary artery bypass grafting (CCABG).Methods Between 40 patients with multivessel coronary disease underwent only coronary artery bypass grafting by one surgeon.They were divided into two groups,AOPCAB group:40 eases underwent CABG with off-pump and beating heart via stemoto- my;CCABG group:20 cases underwent conventional CABG with extracorporeal circulation.Preoperative and postoperative variables of two groups were compared.Results There were no significant difference in diabetes and type of bypass grafts of two groups.Previous thrombolysis or percuta- neous transluminal coronary angioplasty,three-vessel coronary disease and the number of bypass grafts of OPCAB group and CCABG group were,2.9±0.8 and 3.9±1.1(P<0.01) respectively.The assisted respiratory time,hospitalization stay and hospitalization cost of AOPCAB group were significant less than that of CCABG group.But the operative morbidity and mortality of AOPCAB group were less,with no signifi- cance.Conclusion Patients with muhivessel coronary disease underwent OPCAB have less assisted respiratory time,hospitalization stay and hos- pitalization cost than those of CCABG.But so far AOPCAB cannot replace the CCABG,and more clinical trials are necessary for evaluation the early and late results of AOPCAB.
出处
《医学研究通讯》
2004年第10期11-13,共3页
Bulletin of Medical Research
