文章摘要
吴联合 米怀雪 张正升 张申 盛存见.序贯旁路移植同期行内膜剥脱治疗严重弥漫性冠状动脉病变的临床研究[J].,2015,15(24):4693-4695
序贯旁路移植同期行内膜剥脱治疗严重弥漫性冠状动脉病变的临床研究
Clinical Research on Sequential Bypass Graft Combined withEndarterectomy for Sever Diffuse Coronary Artery Disease
  
DOI:
中文关键词: 非体外循环  序贯旁路移植  冠状动脉旁路移植  内膜剥脱  弥漫性冠状动脉病变
英文关键词: Off-pump  Sequential bypass graft  Coronary artery bypass graft  Endarterectomy  Diffuse coronary artery disease
基金项目:2013年济宁市科技计划项目(2013jnwk30)
作者单位
吴联合 米怀雪 张正升 张申 盛存见 济宁市第一人民医院心外科一病区 
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中文摘要:
      目的:探讨严重弥漫性冠状动脉病变患者在非体外循环下行序贯旁路移植手术联合内膜剥脱的临床效果及安全性。方法: 按照随机数字表法将2011 年3 月~2013 年3 月我院收治的110例严重弥漫性冠状动脉病变患者分为治疗组54 例和对照组56 例。治疗组在非体外循环下行序贯旁路移植结合内膜剥脱治疗,对照组在非体外循环下行冠状动脉旁路移植结合内膜剥脱治疗, 比较两组的临床效果及围手术期并发症。结果:治疗组围手术期死亡2 例(3.70%),对照组死亡4 例(7.14%),两组死亡率比较差 异无统计学意义(x2=0.631,P=0.427)。围手术期内治疗组心肌梗死、严重心脑血管不良事件以及新发房颤的发生率低于对照组,差 异有统计学意义(P<0.05)。治疗组术后1 年吻合口通畅程度和桥血管通畅程度均优于对照组,差异均有统计学意义(Z=-2.416,-2. 456;P=0.016,0.014)。结论:在非体外循环下序贯旁路移植同期行内膜剥脱治疗严重弥漫冠状动脉病变具有并发症少、安全性高 且疗效好的特点,值得临床推广使用。
英文摘要:
      Objective:To explore the clinical efficacy and safety of off-pump sequential bypass graft surgery combined with endarterectomy in the treatment of sever diffuse coronary artery disease.Methods:A total of 110 patients with severe diffuse coronary artery disease, admitted to First People's Hospital of Jining from March 2011 to March 2013, were chosen and randomly divided into study group (n=54) and control group (n=56). The study group was treated with off-pump sequential bypass graft combined with endarterectomy, while the control group, off-pump coronary artery bypass graft (CABG) combined with endarterectomy. The clinical effects and perioperative complications were compared between the two groups.Results:In the perioperative period, 2 patients (3.70%) died in study group, and 4 patients(7.14%), in control group,there was no statistical significance in the death rate between the two groups (x2=0.631,P=0.427). The incidence of myocardial infarction,serious cerebral cardiovascular adverse events and emerging atrial fibrillation in the study group were lower than those in the control group during the perioperative period, with statistical significance (P<0.05). One year after operation, the smooth extent of anastomosis and heart bypass vessel of study group were better than those of control group, with statistical significance (Z=-2.416, -2.456; P=0.016, 0.014).Conclusion:Off-pump sequential bypass graft combined with endarterectomy for the patients with severe diffuse coronary artery disease has the advantages of few complications, high safety and excellent effects, which is worthy of clinical application.
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