摘要
目的确定急性心肌梗死(AMI)后行冠状动脉旁路移植术(CABG)时机对术后30 d 死亡率的影响。方法 233病例分为心肌梗死和心绞痛两组,对多个风险因素通过单因素、多因素分析,以确定 AMI后不同时段手术是否为死亡的独立风险因素。结果 233例中男176例(75.4%),女57例(24.5%)。年龄34～86岁,平均(65.6±9.2)岁。平均移植血管(3.46±0.89)支,137例(58.8%)应用乳内动脉137根。总死亡率4.3%(10/233例)。AMI 距手术时间≤3 d 者,手术死亡6例(14.6%,6/41例),较心绞痛组3例(2.3%,3/130例)显著增高(P=0.033);4～10 d 者1例(2.7%,1/37例)与心绞痛组相比差异无统计学意义(P=0.67),11～30 d 者无手术死亡。结论急性心肌梗死3 d 后行冠脉旁路移植术较为安全。
Objective To evaluate the appropriate timing of coronary artery bypass grafting（ CABG）with acute myocardial infarctian（AMI） and to discuss the influence of postoperative mortality on 30 days. Methods 233 patients after CABG were divided into 2 groups, AMI group and unstable angina （UA） group. There were 176 males （75.4%） and 57 females （24.5%）. The mean age was （65.6 ± 9.2） years（range 34 - 86 years）. The mean grafts were 3.46 ± 0.89. The complex risk elements between the 2 groups were analyzed to evaluate the independent risk dement of death. Results Internal mammary arteries were used in 137 patients （58.8 % ）. The postoperative mortality rate was 4.3 % （10/233）. The operative mortality rates（OMR） were closely related to the increasing time intervals between AMI and CABG, for less than 3 days was 14.6 % （6/41 cases ）, for 4 to 10 days was 2.7 % （ 1/37 ） and for 11 to 30 days was 0. The OMR of AMI less than 3 days has significant difference （ P = 0.033） comparing with that of unstable angina pectofis [2.3% （3/130）]. Conclusion Proper timing of CABG shanld be done in 3 days after AMI.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2007年第5期308-310,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
心肌梗塞
冠状动脉分流术
死亡率
Myocardial infarction Coronary artery bypass Mortality
