冠脉旁路移植术中两种乳内动脉游离方法的临床效果对比

发布时间：2018-11-05 10:32

【摘要】：目的:对比分析冠状动脉旁路移植术(CABG)中带蒂法和骨骼化法游离乳内动脉对术后近期结果的影响。方法:选取单纯行CABG的冠心病患者526例为研究对象,分为带蒂法游离乳内动脉组(262例)和骨骼化法游离乳内动脉组(264例),分析两组围术期相关指标、主要术后并发症及随访术后桥血管通畅率等。结果:526例患者全部顺利完成手术。带蒂法游离乳内动脉组动脉桥血流量为(22.8±7.8)m L/min,游离时间为(18.1±5.5)min,获得乳内动脉长度(13.5±0.8)cm;骨骼化法游离乳内动脉组分别为(41.6±8.3)m L/min、(32.5±6.8)min和(15.8±0.9)cm,差异均有统计学意义(P0.05)。带蒂法游离乳内动脉组手术总时间(245±21)min,围术期死亡4例,围手术期心梗12例;骨骼化法游离乳内动脉组分别为(252±18)min、5例和10例,两组各有1例胸骨不愈合,差异均无统计学意义(P0.05)。术后随访3~12个月,两组1 a内动脉桥通畅率均为99.6%。结论:冠脉旁路移植术中,采取骨骼化与带蒂法游离乳内动脉对术后近期效果无明显差异。
[Abstract]:Objective: to compare and analyze the influence of free internal mammary artery in coronary artery bypass grafting (CABG). Methods: a total of 526 patients with coronary heart disease who were treated with CABG alone were divided into two groups: the group with free internal mammary artery (262 cases) and the group with free intramammary artery with skeletal method (264 cases). The indexes related to perioperative period were analyzed in the two groups. The main postoperative complications and the patency rate of graft vessels were followed up. Results: all the 526 patients completed the operation successfully. The arterial bridge blood flow was (22.8 卤7.8) mL / min, and the free time was (18.1 卤5.5) min, to obtain (13.5 卤0.8) cm; of the internal mammary artery. In the free intramammary artery group, the differences were (41.6 卤8.3) mL / min, (32.5 卤6.8) min and (15.8 卤0.9) cm, respectively (P0.05). In the group of free internal mammary artery with pedicle method, the total operative time was (245 卤21) min, perioperative death in 4 cases, and perioperative myocardial infarction in 12 cases. There were (252 卤18) min,5 and 10 cases of free intramammary artery in the group of free intramammary artery by skeletal method, one case of sternal nonunion was found in each group, and there was no significant difference between the two groups (P0.05). After 3 ~ 12 months follow-up, the patency rate of arterial bridge was 99.6 in both groups within 1 year. Conclusion: in coronary artery bypass grafting, there is no significant difference in the short-term effect between free internal mammary artery and skeletal method.
【作者单位】：郑州大学第一附属医院心外科;
【分类号】：R654.2

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