摘要
目的探讨慢性肾功能不全冠心病患者行非体外循冠状动脉旁路移植手术(OPCABG)的临床效果。方法回顾性分析2009年1—11月于北部战区总医院接受单纯OPCABG手术的66例慢性肾功能不全冠心病患者的临床资料。评价纳入患者治疗效果及治疗安全性。结果66例患者中,住院死亡4例(6.06%),死因均为心源性致死;二次开胸止血4例(6.06%)。呼吸机使用时间3~522 h,平均(38.83±68.89)h;ICU停留时间3~713 h,平均(88.88±120.09)h;术后累计平均引流量(1210.26±1071.24)ml;术后住院时间1~49 d,平均(14.80±7.81)d;总住院时间12~67 d,平均(31.09±13.79)d;住院费用7.12~50.56万元,平均(15.92±8.67)万元。输血47例,红细胞平均使用量(4.19±8.13)U,血浆平均使用量(544.39±942.08)ml。66例患者入院时血肌酐和胱抑素C高于正常值,且两项指标术后最高值均高于入院时,但两项指标出院前均明显回落,且接近入院时数值。结论OPCABG治疗伴有慢性肾功能不全的冠心病患者的效果显著,安全性较好。
Objective To investigate the clinical effect of off-pump coronary artery bypass grafting(OPCABG)in patients with coronary atherosclerotic heart disease(CAD)with chronic renal insufficiency(CRI).Methods A retrospective study was performed on 66 cases of patients with CAD with CRI who were admitted and underwent OPCDABG from January to November 2009.To evaluate the therapeutic effect and safety of the included patients.Results After targeted perioperative systematic treatment for 66 patients,4 patients died(6.06%)in hospital after OPCABG operation,4 patients(6.06%)underwent second thoracotomy for hemostasis.The ventilator was used for 3-522 hours with an average of(38.83±68.89)hours.ICU stay time(3-713)hours,average(88.88±120.09)hours.The cumulative average postoperative drainage volume was(1210.26±1071.24)ml.Postoperative hospital stay ranged 1-49 days,with an average of(14.80±7.81)days,and the total hospital stay ranged 12-67 days,with an average of(31.09±13.79)days.Hospitalization expenses ranged 712-505600 yuan,with an average of(159200±86700)yuan.The average amount of red blood cell and plasma was(4.19±8.13)U and(544.39±942.08)ml,respectively.The serum creatinine and cystatin C values of 66 patients were significantly higher than the normal values at admission,and the postoperative maximum values of both indexes were higher than that at admission,but both indexes were significantly lower and close to the values at admission before discharge.Conclusion OPCABG is effective and safe in the treatment of severe CAD patients with CRI.
作者
徐殊
陶登顺
张誉籍
XU Shu;TAO Deng-shun;ZHANG Yu-ji(Department of Cardiovascular Surgery,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《临床军医杂志》
CAS
2020年第12期1427-1429,共3页
Clinical Journal of Medical Officers
基金
辽宁省自然科学基金(20180550847)
关键词
慢性肾功能不全
非体外循环冠状动脉旁路移植术
肌酐
冠心病
Chronic renal insufficiency
Off pump coronary artery bypass grafting
Creatinine
Coronary atherosclerotic heart disease
作者简介
第一作者:徐殊(1980-),男,辽宁抚顺人,主治医师,博士;通信作者:陶登顺,E-mail:taodengshun@hotmail.com
