术前超声定位引导大隐静脉获取在冠脉动脉旁路移植术中的应用效果分析

目的 分析术前超声定位引导在冠状动脉旁路移植术中大隐静脉获取质量和速度的应用效果。方法 分析复旦大学附属中山医院厦门医院自2018年8月～2019年10月所行冠状动脉旁路移植术的患者。术前将患者随机分为超声定位组和对照组。共入选冠状动脉旁路移植术患者78例,超声定位组和对照组各39例,两组一般资料、获取静脉桥长度比较,差异无统计学意义。超声定位组在术前对患者双侧大隐静脉全长进行扫描,测量大隐静脉直径并定位。对照组术前不行超声定位。记录从切开腿部皮肤至缝合完成的时间作为获取时间。记录术后腿部切口愈合情况,观察有无渗出、愈合不良或感染等并发症发生。结果 超声定位组平均获取时间为(48±4)min,对照组为(59±6)min,两组间有统计学差异(P0.05)。超声定位组1例患者术后发生切口血肿,对照组2例患者术后发生切口血肿,1例患者术后发生淋巴管损伤,4例患者术后发生切口愈合不良,1例患者术后发生切口感染,两组术后切口并发症总发生率有统计学差异(P0.05)。结论 通过术前运用血管超声定位大隐静脉的方法指导年轻医生进行获取,能够显著缩短获取时间,减少皮瓣的产生,降低术后切口相关并发症的发生率。该方法简单、有效、经济、无创,值得在临床实践中推广。

Analysis of the effect of preoperative ultrasound positioning guided saphenous vein acquisition in coronary artery bypass grafting

Objective To analyze the application effect of preoperative ultrasound localization guidance in obtaining quality and speed of great saphenous vein in coronary artery bypass grafting.Methods The patients with coronary artery bypass grafting performed in Xiamen Branch,Zhongshan Hospital,Fudan University from August 2018 to October 2019 were analyzed.The patients were randomly divided into ultrasound localization group and control group before surgery.A total of 78 patients with coronary artery bypass grafting were enrolled,39 in the ultrasound localization group and 39 in the control group.There was no significant difference in the general information and length of the venous bridge between the two groups,which were comparable.In the ultrasound localization group,the full length of the bilateral great saphenous vein was scanned before surgery,and the diameter of the great saphenous vein was measured and localized.No ultrasound localization was performed in the control group before surgery.The time from incision of leg skin to completion of suture was recorded as the acquisition time.Postoperative leg incision healing was recorded and the complications such as exudation,poor healing,or infection were observed.Results The average acquisition time of the ultrasound localization group was(48±4)minutes,and that of the control group was(59±6)minutes.There was a statistical difference between the two groups(P<0.05).Postoperative incision hematoma occurred in 1 patient in the ultrasound localization group.There were 2 patients with postoperative incision hematoma,1 patient with lymphatic injury,4 patients with poor healing of the incision,and 1 patient with incision infection in the control group.There were statistically significant differences in the overall incidence of postoperative incision complications between the two groups(P<0.05).Conclusion The use of vascular ultrasound to locate the great saphenous vein before surgery can guide young doctors to obtain acquisition,which can significantly shorten the acquisition time,reduce the generation of skin flaps,and reduce the incidence of postoperative incision-related complications.This method is simple,effective,economical,non-invasive,and worthy of popularization in clinical practice.