使用双侧乳内动脉行冠状动脉旁路移植术动脉桥即时流量的初步研究

发布时间：2018-10-18 08:14

【摘要】：目的:使用双侧乳内动脉行冠状动脉旁路移植术(CABG)后的右乳内动脉(RIMA)桥血管流量分析,初步探讨动脉桥流量特性。方法:2015-12至2016-07选择在我院年龄65岁、使用双侧乳内动脉行CABG患者52例,男46例,平均年龄(56.6±6.8)岁,根据前降支(LAD)移植血管材料分为两组,RIMA-LAD吻合组(n=42),左乳内动脉(LIMA)-LAD吻合组(n=10)。使用Veri Q系统行桥血管即时流量测定,比较手术结果及桥流量。结果:52例患者无手术死亡,1例患者出现伤口愈合不良,行清创缝合,余51例无手术并发症。RIMA-LAD组和LIMA-LAD组患者LAD桥平均流量分别为(28.7±11.5)ml/min和(31.8±11.7)ml/min,平均搏动指数为2.3±0.7和2.0±0.4,差异均无统计学意义(P0.05);两组患者RIMA至不同靶血管平均流量([28.7±11.5)ml/min v(s21.1±11.0)ml/min]、平均搏动指数(2.3±0.7 vs 2.6±1.1),差异均无统计学意义(P0.05)。结论:RIMA-LAD桥流量与LIMA-LAD桥流量相当,RIMA与其他靶血管吻合,桥流量满意,是稳定理想的冠状动脉旁路血管移植物。
[Abstract]:Objective: to investigate the flow characteristics of right internal mammary artery (RIMA) graft after coronary artery bypass grafting (CABG) with bilateral internal mammary artery. Methods: Fifty-two patients (46 males, mean age (56.6 卤6.8) years) with bilateral internal mammary artery (CABG) were divided into two groups according to anterior descending branch (LAD) graft materials: RIMA-LAD anastomosis group (n = 42) and left internal mammary artery (LIMA) LAD anastomosis group (n = 10). The Veri Q system was used to measure the graft blood flow and to compare the surgical results and the graft flow. Results: there was no operative death in 52 patients, and one patient had poor wound healing and underwent debridement and suture. The mean flow rate of LAD bridge in RIMA-LAD group and LIMA-LAD group was (28.7 卤11.5) ml/min and (31.8 卤11.7) ml/min, mean pulsatile index, respectively. There was no significant difference between the two groups (P0.05). The mean flow of RIMA to different target vessels was ([28.7 卤11.5) ml/min v (s21.1 卤11.0) ml/min]. The number (2.3 卤0.7 vs 2.6 卤1.1) had no statistical significance (P0.05). Conclusion: the flow of RIMA-LAD bridge is equivalent to that of LIMA-LAD bridge. RIMA anastomoses with other target vessels and the graft flow is satisfactory. It is a stable and ideal graft of coronary artery bypass.
【作者单位】：中国医学科学院北京协和医学院国家心血管病中心阜外医院成人外科中心;
【分类号】：R654.2

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