冠状动脉旁路移植术602例临床分析

目的 总结行冠状动脉旁路移植术治疗冠心病的经验.方法 回顾性分析602例冠状动脉旁路移植术病例,男性462例,女性140例;应用体外循环519例,非体外循环83例,搭桥1～6(3.62±1.15)支/人.对手术方法、主要并发症和术后处理进行分析总结.结果 二次开胸9例(1.5％),低心排综合征20例(3.3％),应用IABP 15例(2.5％),肝功能不全4例(0.7％),肾功能不全10例(1.7％),反复发作房颤21例(3.5％),肺功能不全12例(2.0％),脑合并症5例(0.8％),胸腔积液55例(9.1％).死亡9例(1.5％),其余患者康复出院.结论 合理地选择适应证,成熟的手术技术,良好的心肌保护及术后处理的加强是提高冠状动脉旁路移植术疗效的重要措施.

Clinical analysis of 602 cases of coronary artery bypass grafting

Objective In order to summarize the results and experience of coronary artery bypass grafting （CABG） for coronary artery disease. Methods A retrospective study was carried out review experience. 602 cases with coronary artery disease underwent CABG, 462 males and 140 females. CABG with cardiopulmonary bypass （CPB） in 519, off-pump CABG in 83. The average number or graft was（3.62±1.15 ）. Surgical methods, complications and post-operative treatment were analyzed. Results Early post-operative complication included： Re-open in 9（1.5%）, LCOS in 20（3.3%）, IABP used in 15（2.5%）, hepatic dysfunction in 4（0.7%）, renal insufficiency in 10（1.7%）, repeatedly atrial fibrillation in 21（3.5% ）, respiratory insufficiency in 12（2.0% ）, complication of CNS in 5（0.8%）, pleural effusion in 55（9.1%） and death in 9（1.5%）. The others had favorable outcomes. Conclusion Suitable indications disease, excellent surgical technique, advanced myocardial protection and enhancing post-operative treatment can significantly improve the results of CABG for the patients with coronary artery disease.