选择性逆向冠状静脉搭桥的解剖学基础与临床应用的研究

发布时间：2018-05-27 16:29

  本文选题：心中静脉 + 猪心　； 参考：《中国医科大学》2005年硕士论文

【摘要】：冠状动脉搭桥术(conventional CABG)虽然已广为接受,但仍面临着一些难题有待于解决。其中之一便是:对弥漫性血管病变远端通畅不良者无法施行CABG。这类患者占搭桥手术候选者的12%～15%,甚至更多。针对弥漫性血管病变远端通畅不良者施行选择性逆向冠状静脉搭桥(selective retrograde coronary venous bypass,SRCVB)的研究,会为给这些患者带来好处。 鉴于此,本研究拟就冠状静脉逆灌程度及临床疗效方面探讨SRCVB。 目的 1 寻找选择性逆向冠状静脉搭桥营养心肌的解剖学证据,从而佐证选择性逆向冠状静脉搭桥(SRCVB)的有效性。 2 通过对SRCVB术式病例手术前后对照分析、OPCABG的病例和同期行SRCVB的病例术后早期心肌酶、肌钙蛋白水平的比较,进一步探讨SRCVB术式的临床应用价值。 方法 1 基础实验 取完整的离体新鲜家猪心脏5个,用25℃生理盐水漂净并取出房室腔内血栓块,从右心房侧剪开冠状静脉窦,用5号头皮针剪去针头后的较柔软硅胶管,轻柔地沿心中静脉插入2.0～2.5cm,用1号丝线于距胶管尖端1.0～1.5cm处胶管上缝扎后室间沟内走行的动静脉1～2道,防止心中静脉回流,并缝闭后降支动脉以模拟其闭塞。先用肝素盐水(500ml生理盐水加
[Abstract]:Although conventional CABG has been widely accepted, it still faces some problems to be solved. One of them was that CABGs could not be performed in patients with diffuse vascular lesions with poor distal patency. These patients account for 12 or more of the bypass surgery candidates. The study of selective retrograde coronary venous Bypass-SRCVBs for patients with diffuse vascular disease with poor distal patency may be beneficial to these patients. In view of this, this study intends to explore the degree of coronary vein reverse perfusion and clinical efficacy of SRCVB. Purpose 1 to search for anatomical evidence of selective reverse coronary vein bypass graft (SRCVB) in order to prove the validity of SRCVB (selective reverse coronary vein bypass graft). 2The clinical application value of SRCVB was further discussed by comparing the levels of cardiac enzymes and troponin in patients with SRCVB before and after operation compared with those who underwent SRCVB at the same time. Method 1 basic experiment Five isolated fresh domestic pig hearts were taken out and treated with normal saline at 25 鈩，

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