75岁以上高龄患者非体外循环下冠脉旁路移植术的远期疗效

发布时间：2019-06-24 14:26

【摘要】：目的分析75岁以上高龄患者行非体外循环下冠脉旁路移植术(OPCAB)的远期疗效及其危险因素。方法 2000年11月~2013年11月,97例75岁以上高龄患者由同一术者完成非体外循环下冠脉旁路移植术。统计重症监护病房(ICU)时间、机械通气时间、术后并发症发生率及死亡率等围术期结果。出院后随访包括全因死亡及主要心脑血管不良(MACCE)事件(心肌梗死、脑血管事件、重复再血管化)。结果围术期死亡3例,在院死亡率3%,随访成功率93.81%,随访时间为(29-192)(95.61±34.07)个月。10年生存率为62%,10年MACCE事件免除率为47.4%。随访期间6例(6.8%)患者进行了重复再血管化,12例(12.37%)患者出现脑血管事件,5例(5.15%)出现心梗。Logistic回归分析显示术前合并高血压(OR=1.388,P=0.043)、糖尿病(OR=1.692,P=0.017)是高龄患者OPCAB术后远期MACCE事件的独立风险预测因素,而不完全再血管化并不会增加术后主要心脑血管不良事件(MACCE)事件发生率。结论高龄冠心病患者行非体外循环下冠脉旁路移植术是一种安全有效的手术方法,远期效果满意。高血压、糖尿病是高龄患者OPCAB术后发生MACCE事件的危险因素,但术后良好地控制血压及血糖可以有效降低MACCE事件的发生率,而不完全再血管化并不会对远期疗效产生不良影响。
[Abstract]:Objective to analyze the long-term efficacy and risk factors of off-pump coronary artery bypass grafting (OPCAB) in patients over 75 years old. Methods from November 2000 to November 2013, 97 patients over 75 years old underwent off-pump coronary artery bypass grafting. The perioperative results of (ICU) time, mechanical ventilation time, postoperative complications and mortality in intensive care unit (ICU) were counted. Follow-up after discharge included all-cause death and major cardiovascular and cerebrovascular adverse (MACCE) events (myocardial infarction, cerebrovascular events, repeated revascularization). Results three cases died during perioperative period, the mortality in hospital was 3%, the success rate of follow-up was 93.81%, the follow-up time was (29 鈮，

本文编号：2505132