冠状动脉旁路移植术后院内传导阻滞的临床分析

目的 分析冠状动脉旁路移植术(CABG)后住院期间传导阻滞发生及转归的相关因素.方法 将2005年1月至2006年12月在我院行单纯CABG的649例患者按照术前合并传导阻滞情况分为3组:无传导阻滞组(N组)586例,高位传导阻滞组(A组)27例,低位传导阻滞组(B组)36例.记录围手术期各项指标及术中旁路重建情况.结果 N组术后住院期间8.02%发生高位传导阻滞,8.7%发生低位传导阻滞;出院时4.61%仍合并传导阻滞.A组术后住院期间59.21%仍为高位传导阻滞,3.7%出现低位传导阻滞;出院时29.63%仍合并传导阻滞.B组术后住院期间至出院时86.11%仍为传导阻滞.结论 CABG术后新发传导阻滞大多数为可恢复性,高龄可能是术后新发高位传导阻滞的高危因素,而术前心脏结构、功能,冠脉病变程度以及术中心肌损伤,可能与术后新发低位传导阻滞相关.术前合并高位传导阻滞患者在术后多数可以恢复正常,可能与年龄和术前应用药物有关.术前合并低位传导阻滞患者在术后仅有少部分可能恢复正常,采用off-pump手术、减少术中心肌损伤可能是其相关因素.

Clinic analysis of conduction defects following isolated coronary artery bypass grafting

Objective To analysis the incidence and natural history of conduction defects( CD) following isolated coronary artery bypass grafting ( CABG).Methods Classified the 649 cases undergoing isolated CABG from Jan 2005 to Dec 2006 to three groups according to accompanying with conduction defects pre -operation,non-CD( N group)586 cases,CD above bundle of His( A group) 27 cases,and CD below bundle of His( B group) 36 cases.Collected the peri-operative data and operative strategy.Results 8.02% cases in N group occ...