143例微创冠状动脉旁路移植术有效性和安全性的倾向性评分匹配研究

目的 对比微创冠状动脉旁路移植术(minimally invasive coronary artery bypass grafting,MICABG)和常规开胸搭桥围术期临床效果,分析MICABG的有效性和安全性.方法 收集2017年1月至2020年9月北京安贞医院单医疗组接受不停跳冠状动脉旁路移植术患者共543例,其...

Safety and effectiveness of minimally invasive coronary artery bypass grafting in 143 patients:A propensity-score matching study

Objective To investigate the safety and effectiveness of minimally invasive coronary artery bypass grafting(MICABG)through comparing the perioperative clinical effects of conventional surgery and MICABG.Methods A total of 543 patients in the single medical group of Beijing Anzhen Hospital who underwent beating coronary artery bypass grafting from January 2017 to September 2020 were collected,including 161 patients receiving MICABG(a minimally invasive group,143 males and 18 females,aged 60.08±9.21 years),382 patients receiving median thoracotomy(a conventional group,284 males and 98 females,aged 61.68±8.81 years).The propensity score was used to match 143 patients in each of the two groups,and the perioperative data of the two groups were summarized and analyzed.Results There was no death,perioperative myocardial infarction or stroke in the minimally invasive group.Compared with the conventional group,the minimally invasive group had longer operation time(296.36±89.4 min vs.217.80±50.63 min,P=0.000),less number of bypass grafts(2.86±1.03 vs.3.17±0.78,P=0.005),shorter postoperative hospital stay(6.29±1.46 d vs.6.78±2.61 d,P=0.031),less drainage on postoperative day 1(339.57±180.63 mL vs.441.92±262.63 mL,P=0.001)and lower usage rate of inotropic drugs(9.09%vs.26.57%,P=0.001).There was no statistical difference between the two groups in postoperative ICU stay ventilator assistance time,blood transfusion rate,secondary thoracotomy rate,or use of mechanical equipment.Conclusion Reasonable clinical strategies can ensure the satisfactory overall safety of MICABG.In addition,it has the advantages of shorter postoperative hospital stay,less bleeding and smaller dosage of inotropic drugs.