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非体外循环冠状动脉旁路移植术在低射血分数患者中的应用体会 被引量:1

Application experience of off-pump coronary artery bypass grafting in patients with low ejection fraction
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摘要 目的:总结对低射血分数(EF≤35%)冠心病患者进行的非体外循环冠状动脉旁路移植术(OPCABG)的临床体会。方法:回顾性分析我院2000年9月~2008年12月对18例射血分数≤35%的冠心病患者进行的OPCABG手术的临床资料、手术结果,总结围术期临床治疗体会。结果:其中16例完成了OPCABG术,2例中途改为体外循环辅助且心脏不停跳下完成CABG;18例患者行旁路移植2~5支,平均(3.10±0.5)支;18例均使用主动脉内球囊反搏,其中,16例是在未开胸前安放,2例是在术中安放。围术期死亡4例,死亡率为22.2%。结论:低射血分数(EF≤35%)的冠心病患者实施OPCABG术有良好的可行性和效果,IABP的应用、尽可能地完全再血管化、围术期正确的管理是确保手术治疗效果的关键,而长期预后仍有待进一步观察。 Objective: To summarize the low ejection fraction (EF≤35%) of coronary heart disease in patients with offpump coronary artery bypass grafting (OPCABG) clinical experience. Methods: Retrospective analysis of our hospital during September 2000 to December 2008, 18 cases of ejection fraction≤ 35% of patients with coronary heart disease, clinical data OPCABG surgery, surgical results, the aggregate perioperative clinical treatment. Results: The results of which 16 cases completed OPCABG surgery, two cases of half-way but changed to off-pump beating heart assisted the completion of CABG, 18 patients bypass line 2-5[an average of (3.10±0.5) sticks], 18 cases used aortic balloon pump, of which 16 cases did not open chest in place, in 2 cases during installation. Perioperative death of 4 cases, the mortality rate was 22.2%. Conclusion: Low ejection fraction(EF≤ 35%) of coronary heart disease OPCABG surgery patients have a good feasibility and effectiveness, IABP application, as far as possible the complete revascularization, perioperative management is key to ensure the correct surgical treatment effect, the long-term prognosis remains to be further observed.
出处 《中国医药导报》 CAS 2009年第13期252-253,共2页 China Medical Herald
关键词 冠状动脉旁路移植术 非体外循环 低射血分数 Coronary artery bypass grafting Off-pump Low ejection fraction
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