摘要
目的探讨70岁及以上男性患者行非体外循环冠状动脉旁路移植术（OPCABG）的短期和中期临床疗效。方法收集2008年1月至2009年2月于首都医科大学附属北京安贞医院择期行OPCABG的100例70岁及以上男性冠状动脉硬化三支病变患者的临床资料进行回顾性分析。以术后氧合指数为因变量进行多元线性回归分析，应用Kaplan．Meier法进行患者术后100个月生存情况分析。结果100例男性患者年龄70-81岁，平均（73．1±2．5）岁，院内病死率为2．0％（2／100）。影响术后氧合指数的独立因素为吸烟史、术中输入血浆量、左心室射血分数〈40％、室壁瘤和心肌梗死病史（均P〈0．05）。出院患者随访100个月，失访率为15．3％（15／98）。患者术后第1年存活率为95．3％（81／85），第2年为94．1％（80／85），第3年为91．8％（78／85），第7年为83．5％（71／85），第100个月为81．2％（69／85）。第100个月无心绞痛存活率为78．8％（67／85）。结论高龄（≥70岁）老年男性冠状动脉硬化三支病变患者行OPCABG是可行的。院内病死率和术后100个月存活率均在可接受范围内。
Objective To investigate the short- and mid-tetm efficacies of off-pump coronary artery bypass grafting（OPCABG） in male patients over 70 years old. Methods Perioperative data of 100 male patients 70 years or older who had OPCABG from January 2008 to February 2009 in Beijing Anzhen Hospital, Capital Medical University were retrospectively analyzed. Risk factors of postoperative oxygen index （OI） were identified by multivariate linear regression. Survival analysis was performed by Kaplan-Meier method during 100 months after operation. Results The mean age of 100 patients was （73. 1 ± 2. 5 ） years ; the in-hospital mortality was 2. 0% （2/100）. Smoking history, intraoperative plasma transfusion volume, left ventricular ejection fraction less than 40%, ventricular aneurysm history and myocardial infarction history were independent factors of postoperative OI （P 〈 0. 05）. The lost of follow-up rate was 15.3% （ 15/98 ） ; 1-year survival rate was 95.3% （ 81/85 ） ; 2-years survival rate was 94. 1% （80/85） ; 3-years survival rate was 91.8% （78/85） ; 7-years survival rate was 83.5% （71/85 ） ; the survival rate and angina-free survival rate at 100 months after operation was 81.2% （69/85） and 78.8% （67/85）. Conclusion Outcomes of OPCABG in male patients over 70 years old are encouraging; the in-hospital mortality and 100 months survival rate are acceptable.
出处
《中国医药》
2017年第2期187-190,共4页
China Medicine
作者简介
通信作者：金沐，Email：jinmu0119@hotmail．com.
