摘要
目的探讨术前血肌酐重度升高患者非体外循环冠状动脉旁路移植术(OPCABG)后的短、中期预后情况。方法选择2012年2月-2016年7月在北京安贞医院行OPCABG、术前血肌酐重度升高(≥1.5倍正常值上限)的46例患者,分析围术期并发症、住院死亡发生率和中期预后。结果 46例患者年龄45~85(65.4±8.5)岁,院内死亡发生率为4.4%。术中行紧急体外循环1例(2.2%),术中发生心室纤颤2例(4.4%),术后行院内持续肾脏替代治疗(CRRT)9例(19.6%)。术后1年存活率100%,2年存活率97.6%。13例(28.3%)患者术后营养状况评分≤11分。结论术前血肌酐重度升高患者行OPCABG术后的住院死亡发生率及术后2年存活率在可接受范围内,大部分患者术后营养状况良好,具有临床可行性。
Objective To investigate the short- and mid-term outcomes of after off-pump coronary artery bypass grafting （OPCABG） in patients with severe elevation of preoperative serum creatinine levels （SEPSC）. Methods The perioperative data of SEPSC patients undergoing OPCABG were investigated based on the perioperative CABG database from Feb. 2012 to Jul. 2016. The patients were also followed up for the perioperative complication, short and medium-term survival were estimated. Results The mean age of the patients was 65.4（45-85） years. The in-hospital mortality was 4.4% and the CRRT rate was 19.6%（9 case）. Survival analyses revealed a survival ratio of 100% at one year, 97.6% at two years. Short-Form Mini Nutritional Assessment was used to show that 13（28.3%） patients had malnutrition. Conclusions SEPSC patients can be candidates for OPCABG procedure. The mortality in hospital and 2-year survival rate of SEPSC patients after OPCABG procedure are both considered within an acceptable range. OPCABG may be performed in these patients with a satisfactory survival rate with the development of surgical instruments and medical treatment.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2017年第6期545-548,共4页
Medical Journal of Chinese People's Liberation Army
