70岁以上冠心病患者冠状动脉搭桥术62例分析

目的回顾70岁以上高龄冠心病患者行冠状动脉旁路移植术的结果和围手术期处理策略。方法对70岁以上62例均为多支病变的冠心病患者行冠状动脉旁路移植术。体外循环下手术42例,非体外循环下手术20例。平均移植血管2.8±1.3支。结果围手术期死亡3例,死亡率5%,其中2例为急诊手术。结论70岁以上冠心病患者行冠状动脉旁路移植术可改善患者症状,缓解心绞痛,提高生活质量,与一般患者相比死亡率无明显增加。但对于高龄患者应注意术前合并症,如糖尿病、高血压的处理以及术后心功能和呼吸功能的管理。

Coronary Artery Bypass Grafting in the Elderly Patients Above Seventy Years Old with Coronary Heart Disease

Aim To discuss the characteristics and experience of coronary artery bypass grafting (CABG) in the elderly patients above seventy years old with coronary heart disease (CHD). Methods There were 62 cases of patients with CHD over 70 years old. The operative techniques and postoperative management of CABG were analyzed retrospectively. Results Three cases were postoperatively died and the mortality rate is 5%. The postoperative main complications were cardiac arrhythmias, low cardiac output syndrome and pulmonary infection. Conclusion CABG for patients over 70 years old could alleviate the symptom,relieve anginapectoris and improve life quality. The mortality rate of these patients is not higher than that of other patients. Special attention should be paid to the management of preoperative complications such as diabetes mellitus, hypertension and the management of postoperative cardiac and respiratory function.