同期颈动脉支架术及冠状动脉旁路移植术治疗颈动脉狭窄合并冠心病的疗效分析
发布时间：2018-11-07 14:23
【摘要】：目的:探讨同期颈动脉支架术(CAS)及冠状动脉旁路移植术(CABG)治疗颈动脉狭窄合并冠心病的安全性与疗效。方法:回顾性分析中日友好医院2007年1月 2014年12月收治的25例颈动脉狭窄合并冠心病患者资料,其中11例同期行CAS和CABG(同期组),14例分期行CAS和CABG(分期组),比较两组患者的主要临床指标。结果:两组患者术前基本资料具有可比性。所有患者手术均获成功,无围手术期死亡患者。与分期组比较,同期组中位手术时间(250minvs.280min)、中位住院时间(19dvs.24d)明显缩短(均P0.05),中位术中出血量(750m Lvs.600m L)、输血量(1000m Lvs.1200m L)、ICU时间(23hvs.24h)、呼吸机时间(19hvs.16.5h)差异均无统计学意义(P0.05)。同期组出现术后30d内小卒中1例,一过性脑缺血发作(TIA)1例,围手术期肺部感染1例,术后短暂低血压3例;分期组出现TIA2例,术后短暂低血压4例,再次开胸止血1例,围手术期肺部感染1例,两组均无心肌梗死及死亡病例。结论:同期和分期行CAS和CABG治疗颈动脉狭窄合并冠心病均安全有效,同期手术可以缩短手术和住院时间,应根据患者的病变特点选择合适的治疗方法。
[Abstract]:Objective: to evaluate the safety and efficacy of simultaneous carotid stenting (CAS) and coronary artery bypass grafting (CABG) in the treatment of carotid artery stenosis with coronary heart disease. Methods: the data of 25 patients with carotid artery stenosis complicated with coronary heart disease in China-Japan Friendship Hospital from January 2007 to December 2014 were retrospectively analyzed. Among them, 11 cases were treated with CAS and CABG (simultaneous group) and 14 cases with CAS and CABG (staging group). The main clinical indexes of the two groups were compared. Results: the basic data of the two groups were comparable before operation. All patients were successfully operated without perioperative death. Compared with the staging group, the median operative time (250minvs.280min), median hospitalization time (19dvs.24d) and blood loss during operation (750m Lvs.600m L),) (1000m Lvs.1200m L),) were significantly shortened in the same group (P0.05). ICU time (23hvs.24h) and ventilator time (19hvs.16.5h) were not significantly different (P0.05). In the same group, there were 1 case of stroke, 1 case of transient ischemic attack of (TIA), 1 case of perioperative pulmonary infection and 3 cases of transient hypotension. TIA2 appeared in the staging group, hypotension occurred in 4 cases, rethoracotomy hemostasis occurred in 1 case and pulmonary infection in the perioperative period in 1 case. There were no myocardial infarction or death cases in both groups. Conclusion: CAS and CABG are safe and effective in the treatment of carotid artery stenosis complicated with coronary heart disease at the same time and CABG can shorten the operation and hospitalization time. The appropriate treatment should be selected according to the pathological characteristics of the patients.
【作者单位】： 中日友好医院心脏血管外科;北京协和医学院研究生院;
【基金】：中日友好医院院级科研基金资助项目(2014-1-QN-1)
【分类号】：R654.2
[Abstract]:Objective: to evaluate the safety and efficacy of simultaneous carotid stenting (CAS) and coronary artery bypass grafting (CABG) in the treatment of carotid artery stenosis with coronary heart disease. Methods: the data of 25 patients with carotid artery stenosis complicated with coronary heart disease in China-Japan Friendship Hospital from January 2007 to December 2014 were retrospectively analyzed. Among them, 11 cases were treated with CAS and CABG (simultaneous group) and 14 cases with CAS and CABG (staging group). The main clinical indexes of the two groups were compared. Results: the basic data of the two groups were comparable before operation. All patients were successfully operated without perioperative death. Compared with the staging group, the median operative time (250minvs.280min), median hospitalization time (19dvs.24d) and blood loss during operation (750m Lvs.600m L),) (1000m Lvs.1200m L),) were significantly shortened in the same group (P0.05). ICU time (23hvs.24h) and ventilator time (19hvs.16.5h) were not significantly different (P0.05). In the same group, there were 1 case of stroke, 1 case of transient ischemic attack of (TIA), 1 case of perioperative pulmonary infection and 3 cases of transient hypotension. TIA2 appeared in the staging group, hypotension occurred in 4 cases, rethoracotomy hemostasis occurred in 1 case and pulmonary infection in the perioperative period in 1 case. There were no myocardial infarction or death cases in both groups. Conclusion: CAS and CABG are safe and effective in the treatment of carotid artery stenosis complicated with coronary heart disease at the same time and CABG can shorten the operation and hospitalization time. The appropriate treatment should be selected according to the pathological characteristics of the patients.
【作者单位】： 中日友好医院心脏血管外科;北京协和医学院研究生院;
【基金】：中日友好医院院级科研基金资助项目(2014-1-QN-1)
【分类号】：R654.2
【相似文献】
相关期刊论文 前10条
1 胡立;颈动脉狭窄的术前诊断[J];天津医药;2004年02期
2 赵志青,景在平,陆清声,包俊敏,冯翔,赵s，
本文编号：2316633
本文链接：https://www.wllwen.com/yixuelunwen/waikelunwen/2316633.html
最近更新
教材专著
