摘要
目的总结106例冠状动脉搭桥术的临床经验.方法对1997年11月～2004年12月进行冠状动脉搭桥术的106例病人进行临床分析.全组男85例,女21例;平均年龄(58.71±8.27)岁;其中陈旧性心肌梗死48例,不稳定性心绞痛63例,合并高血压54例,糖尿病39例,脑梗死病史9例,左室室壁瘤15例,主动脉瓣关闭不全2例,二尖瓣关闭不全2例,主动脉窦瘤破裂1例及经皮冠状动脉介入治疗术后再狭窄2例.超声心动图测左室射血分数(53.7±8.6)%(67%～35%);＜50% 13例,其中＜40% 3例.全组行常规体外循环下冠脉搭桥手术76例,行非体外循环心脏跳动下冠脉搭桥手术30例.结果全组共行动脉桥吻合126支,静脉桥334支.围术期并发症:低心排7例,肺功能衰竭3例,肾功能衰竭4例.围术期死亡4例,病死率3.8%.结论准确的适应症选择、手术,以及适当的围术期处理是确保手术成功的关键.
Objective To review the clinical experience in 106 patients undergone coronary artery bypass grafting（CABG）. Methods One hundred and six patients underwent CABG from Nov. 1997 to Dec. 2004 were reviewed. Of 85 males and 21 females with a mean age of（58.71 ± 8.27）years. There were 48 cases with the history of myocardial infarction, 63 cases with unstable angina, 54 cases with hypertension , 39 cases with diabetes, 9 cases with history of cerebral infarction, 15 cases with left ventricular aneurysm, 2 cases with aortic valve regurgitation, 2 cases with mitral valve regurgitation, 1 case with ruptured aneurysm of aortic sinus and 2 cases with restenosis post percutaneous transcoronary interventional therapy. Left ventricle ejection fraction53.7 ± 8.6（67 % - 35% ）, of 13 cases 〈 50%, 3 cases 〈 40% included. Among them 76 cases performed with conventional CABG, and 30 cases with off- pump coronary artery bypass grafting（OPCAB）. Results The numbers of arterial grafts and venous grafts were 126 and 334 respectively. Postoperative complications were low output syndrome 7 cases and respiratory failure 3 cases, renal insufficiency 4 cases. There were 4 postoperative deaths with a mortality rate 3.8 % . Conclusion Proper selection, early detection and correct management of postoperative complications are important to ensure the operation success.
出处
《宁夏医学院学报》
2005年第4期266-268,共3页
Journal of Ningxia Medical College
关键词
冠状动脉搭桥术
高血压
心肌梗死
围术期处理
comomary artery bypass grafting
hypertension
myocardial infarction
peropertive management
