摘要
目的探讨体外循环与非体外循环下冠状动脉旁路移植术(CABG)的临床效果及对患者生活质量和运动能力的影响。方法 2005年1月～2009年6月该院心胸外科行CABG的冠状动脉粥样硬化性心脏病(冠心病)患者58例,按手术方式的不同分为体外循环下CABG手术组(A组)和非体外循环下CABG手术组(B组),术后两组均进行系统的康复训练。对比分析两组患者手术时间、搭桥支数、术后机械通气时间、住院时间及引流量、输血量、并发症发生率等情况;术后6个月使用简明健康调查量表(SF-36)和6min步行试验评估患者的生活质量和运动能力。结果 B组在心律失常、肺部并发症、引流量、输血量、血管活性药物使用等方面优于A组,手术时间、住院时间及呼吸机辅助时间也明显少于A组(均P<0.05)。两组在搭桥支数、神经系统并发症等方面差别无统计学意义(均P>0.05)。随访6个月后,SF-36量表生活质量评价结果显示B组生理职能(RP)、总体健康(GH)、活力(VT)、情感职能(RE)显著高于A组(均P<0.05);B组6min步行试验评分也显著高于A组(P=0.01)。结论非体外循环下冠状动脉旁路移植术比非体外循环方式更加安全有效,并有助于患者运动能力的提高和生活质量的改善。
【Objective】 To compare the clinical outcomes and the effects of rehabilitation on the life quality and exercise capacity in patients after on-pump and off-pump coronary artery bypass grafting （CABG）. 【Methods】The data of 58 patients underwent CABG from January 2005 to June 2009 were retrospectively analyzed. According to treatment method, patients were divided into two groups： group A underwent on-pump CABG, and group B under-went off-pump CABG. After operation, all patients were guided regularly for rehabilitation. The groups of patients were compared in terms of parameters such as the operation time, average number of graft, post-operation mechanical ventilation time, the length of the hospital stay, quantity of drainage and transfusion, incidence of complication, et al. All patients were surveyed with the MOS item short form health survey （SF-36） and 6 min walking test on 6 months after operation.【Results】Group B had numerous advantages over group A in aspect of incidence of arrhythmia and lung complications, quantity of drainage and transfusion, utilization of vasoactive medicine. Group B also had shorter operation, the length of the hospital stay and post-operation mechanical ventilation time （All P 0.05）. The SF-36 scores of role physical （RP）, general health （GH）, vitality （VT） and role emotional （RE） in group B were higher than those in group A （All P〈0.05）. The result of 6MWT was also higher in group B than that in group A （P=0.01）.【Conclusion】Compared with on-pump CABG, off-pump CABG can improve the early clinical outcome and the life quality and exercise capacity in patients with cardiovascular disease.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第12期1853-1856,共4页
China Journal of Modern Medicine
