摘要
目的对比研究体外循环下冠状动脉搭桥术(CABG)与非体外循环冠状动脉搭桥术(OPCAB)吻合口质量及心肌再血管化的程度。方法连续记录150例OPCAB及120例CABG患者的临床资料,采用t检验或!2检验,对两组相关指标进行对比分析。结果OPCAB与CABG两组比较,术前合并症脑血管事件分别为(26例vs11例)、合并肾功能不全(11例vs6例),OPCAB组较CABG组多且有显著性差异(P<0.05)。术后机械通气时间〔(4.1±2.6)hvs12.5±8.4)h〕、ICU天数〔(1.9±0.5)dvs(2.3±0.8)d〕、住院天数〔(5±2)dvs(7±3)d〕,以及术后并发症的发生率均有显著性差异(P<0.05)。而平均搭桥支数〔(3.1±0.7vs(3.4±0.8)〕、平均动脉桥支数〔(1.3±0.5)vs(1.5±0.7)〕、有质量问题桥血管数(6/465vs4/406)、桥血流波形图、桥血流量、PI值、死亡率(0.8%vs1.6%)两组无明显差异。结论OPCAB能取得与CABG相同的血管桥吻合口质量和血管桥流量及相同的心肌再血管化及动脉化程度,但术前合并症OPCAB组较CABG组多,而术后并发症则少于CABG组。
Objective To investigate the quality of anastomosis and the degree of myocardial revascularization in on-pump CABG and off-pump CABG. Methods From Sept 2003 to Jan 2005, 150 cases undergone off-pump CABG （OPCAB group） and 120 cases undergone on-pump CABG （CABG group） in clinical database were selected. Multiple related index were analysed by t-test or Chi square test. Results The occurrence of preoperative combinations such as brain infarct, kidney dysfunction of the OPCAB group were higher compared with CABG group （P〈0.05）. The parametres such as the mean duration of postoperative ventilation support [（4.1±2.6）h vs （12.5±8.4）h）], days in the ICU [（1.9±0.5）d vs （2.3±0.8）d）] or in hospital [（5±2）d vs（7±3）d）] and postoperative complications of OPCAB group were better than those in CABG group （P〈0.05）. But there was no difference in the parameter including the mean number of grafts [（3.1±0.7） vs （3.4±0.8）], artery grafts and revised grafts [（1.3±0.5） vs （1.5±0.7）], mean blood flow, PI value, flow curve and perioperative mortality （0.8% vs 1.6%）. Conclusions Both OPCAB and on-pump CABG are effective ways for surgical treatment of CAD, and there is no difference in the quality of anastomosis and the degree of revascularization. However, the occurrence of preoperative combinations in OPCAB group are higher, while postoperative complications are fewer than that in CABG group.
出处
《北京医学》
CAS
2006年第5期257-259,共3页
Beijing Medical Journal
