采集大隐静脉为冠状动脉旁路移植桥血管：间断小切口与传统长切口的优缺点比较

背景：在冠状动脉旁路移植过程中，大隐静脉仍为最常用的桥血管材料，但采集难度较高。 目的：探讨冠状动脉旁路移植中使用间断小切口及传统长切口采集大隐静脉的优缺点。 方法：纳入258例采集大隐静脉的冠状动脉旁路移植患者，其中间断小切口法采集大隐静脉112例，传统长切口法146例。观察采集大隐静脉时间、切口长度、缝合时间、总手术时间及术后切口并发症发生率。 结果：间断小切口组采集大隐静脉时间长于传统长切口组(P < 0.05)。切口长度、缝合时间明显短于传统长切口组(P < 0.01)，总手术时间两组比较，差异无显著性意义(P > 0.05)。术后12 d腿部切口间断小切口组并发症发生率明显小于传统长切口组(P < 0.01)，在合并糖尿病患者中，传统长切口组腿部切口并发症发生率明显高于间断小切口组(P < 0.01)。提示，虽然间断小切口采集大隐静脉时间较长，但腿部并发症发生率明显减少，尤其适合于冠心病合并糖尿病患者。

Collection of greater sapheous vein for coronary bypass grafting: Multiple interrupted incisions versus a single incision

BACKGROUND: The greater saphenous vein is common used as bypass grafts during coronary bypass grafting, but it is hard to collect. OBJECTIVE: To investigate advantages and disadvantages between multiple interrupted incisions and traditional single incision in harvesting the greater saphenous vein. METHODS: Harvesting time of great saphenous vein, total incision length, suture time, total operation time and incidence of the post operative wound complications were observed in 258 coronary artery bypass grafting patients, who underwent great saphenous vein harvesting by either multiple interrupted incisions (n=112) or traditional single incision (n=146) . RESULTS AND CONCLUSIONS: Harvesting time of great saphenous vein by using the interrupted incision was significant longer than that using traditional single incision (P < 0.05). However, suture time of the interrupted incision group was shorter than those in the traditional single incision group (P < 0.01). There was no difference between two groups in total operation time (P > 0.05). Complication rate in 12 days after the operation of the leg wound in interrupted incision group was significantly less than that in the traditional single incision group (P < 0.01). Complication rate of the traditional single group for patients with diabetes was significantly higher than that in the interrupted incision group (P < 0.01). Interrupted incisions significantly reduced incidence of leg complications, especially for patients with diabetes and complicated coronary heart disease, although it increased harvesting time of the great saphenous vein.