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目的：比较研究冠状动脉移植术中应用内窥镜获取大隐静脉及传统切开方式获取大隐静脉术后桥血管通畅率。方法：选择 2012 年 2 月 ~2013 年 2 月在我院接受冠状动脉旁路移植术患者的临床资料，根据手术方式的不同，将患者分为内窥镜组（ EVH， n=178）和开放手术组（ OVH， n=202）。术后 1 年行冠脉 CT 检查，观察两组患者桥血管通畅情况。结果：术中无不良事件发生。 EVH 组术中共计完成静脉桥血管总数为 376 支，平均每例 2.11 支。术后 1 年行冠脉 CT 检查，失访 19 例（静脉桥血管 43 支），发生桥血管再狭窄总数为 21 支 / 共 333 支，平均每例为 0.0631 支。 OVH 组术中共计完成静脉桥血管总数为 458 支，平均每例 2.27 支。术后 1 年行冠脉 CT 检查，失访 11 例（含静脉桥血管 31 支），发生桥血管再狭窄总数为 26 支 / 共 427 支，平均每例为 0.0609 支。统计学分析显示两组间比较无明显统计学差异， P>0.05。结论：冠状动脉移植术中应用内窥镜获取大隐静脉与传统切开方式获取大隐静脉相比较，在术后 1 年时桥血管通畅率无明显统计学差异。

英文摘要:

Objective:To compare the patency rate of saphenous vein bypass graft by endoscopic vein harvesting (EVH) and traditional open vein harvesting (OVH) in coronary artery bypass grafting (CABG).Methods:380 coronary heart disease (CHD) cases underwent CABG in our hospital from February 2012 to February 2013 were admitted and divided into EVH group (n=1 78) and OVH group (n=202) according to the different ways of harvesting great saphenous vein. Coronary artery CT was applied one year after the surgery to observe the patency of saphenous vein bypass graftResults:No intraoperative adverse events occurred. A total of 376 vein grafts were completed in EVH group. 19 cases lost follow-up and coronary artery CT examination one year after the surgery showed that 21 out of remained 333 grafts occurred vascular restenosis. 458 vein grafts were completed in OVH group. 1 1 cases lost follow-up and coronary artery CT examination one year after the surgery showed that 26 out of remained 427 grafts occurred vascular restenosis. Statistical analysis demonstrated that no significant differences existed between the two groups (P ＜ 0.05).Conclusion:No obvious statistical differences existed in saphenous vein bypass graft patency rate by endoscopic vein harvesting and traditional open vein harvesting in coronary artery bypass grafting.

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