摘要
目的比较非体外循环冠状动脉旁路移植术(OPCABG)与常规冠状动脉旁路移植术(CCABG)的早、中期临床疗效、通畅率、病理生理、血流动力学的差别。方法选择同一时期80例不稳定型心绞痛患者,按不同的手术方式分为OPCABG组和CCABG组,每组各40例。术中测量两组旁路血管血流量、比较术后4 h、12 h、1 d、3d、5 d心肌肌钙蛋白I(cTnI)水平、移植血管数量、24 h引流量、输库血量、呼吸机辅助时间等。结果两组患者旁路血管流量、搏动指数间差别无显著性意义(P>0.05);OPCABG组患者24 h引流量、呼吸机辅助时间、输库血量、住ICU时间均少于CCABG组(P<0.05),cTnI水平在术后4 h、12 h、1 d均明显低于CCABG组,差异有显著性意义(P<0.05)。结论体外循环冠状动脉旁路移植术可减少心肌损伤和呼吸功能损害,减少术后出血和输血,缩短住院时间,是一种安全、有效的治疗冠状动脉疾病的方法,但远期效果还有待随访,OPCABG不能完全代替CCABG。
Objective To compare the differences in clinical effect, grafts patency, pathophysiology, and hemodynamics in the early and middle stages of off- pump coronary bypass grafting （OPCABG） and conventional coronary bypass grafting （CCABG）. Methods 80 patients with instable angina in the same period were divided into two groups, OPCABG group and CCABG group according to the surgical pattern, with 40 patients in each group. The blood volume of bypass during the portative period was measured, Cordial tropin I （cTnI） before operation and at 4, 12 hours, and 1,3,5 days after operation was measured, and the number of graft vessels, ventilation time, volume of drainage in 24 hours and blood transfusion volume, were compared. Results No significant difference was found in graft patency and stroke index between the OPCABG and CCABG groups （ P 〉0. 05）. Significant difference was found in cTnI volume at 4, 12 hours, 1 day after operation between two groups （ P 〈 0. 01 ）. In OPCABG group, ventilation time, volume of drainage and blood transfusion, and stay time at ICU were significantly less than those in CCABG group. The volumes of cTnI at 4, 12 hours, and 1 day after operation in OPCABG group were significantly lower than those in CCABG group （ P 〈 0. 05）. Conclusion OPCABG is safe and effective for the treatment of coronary disease. The injuries of it were minimal, but it can not completely replace CCABG.
出处
《中国全科医学》
CAS
CSCD
2006年第7期561-562,共2页
Chinese General Practice
