老年冠心病患者非体外循环及体外循环冠状动脉旁路移植术疗效比较

目的 比较非体外循环冠状动脉旁路移植术(OPCABG)及体外循环冠状动脉旁路移植术(CCABG)治疗老年冠心病患者的疗效.方法 选择2015年1月至2017年6月安阳市人民医院年龄≥60岁的冠心病患者152例,按照手术方式不同分为CCABG组83例和OPCABG组69例,比较两组患者围手术期相关指标,并应用中文版健康状况调查表(SF-36)评估患者术前和术后6个月生活质量.结果 两组静脉桥血管远端吻合口数、手术时间、二次开胸率及围手术期死亡例数比较差异无统计学意义(P>0.05);OPCABG组输血量、呼吸机支持时间、ICU天数、住院天数及并发症发生率显著低于CCABG组,差异有统计学意义(P<0.05).OPCABG组SF-36的社会功能、精神功能、总体活力、情感职能及总体健康评分显著高于CCABG组,差异有统计学意义(P<0.05);两组患者在SF-36的躯体疼痛、生理功能及生理职能评分差异无统计学意义(P>0.05).结论 OPCABG治疗老年冠心病患者临床疗效显著,具有手术创伤少,术后并发症少,康复时间短等优点,有利于提高术后生活质量.

Efficacy comparison of off-pump with on-pump coronary artery bypass grafting in elderly patients with coronary heart disease

Objective To compare the efficacy between off-pump coronary artery bypass grafting (OPCABG) and conventional coronary artery bypass grafting ( CCABG) in treatment of those elderly patients with coronary artery diseases ( CHD) . Methods A total of 152 elderly patients ( no less than 60 years old) with CHD admitted in our hospital between Jan 2015 and Jun 2017 were collected, and then divided into the CCABG group of 83 cases and the OPCABG group of 69 cases according to their operation plans. The perioperative relevant indicators between the two groups were compared, and the short-form 36-item (SF-36) health survey questionnaire (Chinese edition) was used to assess their postoperative quality of life. Results There was no significant difference between the two groups in the number of distal anastomotic vessels of vein grafts, operation duration, rate of twice thoracotomy and deaths in perioperative duration (all P>0. 05). But the blood transfusion volume, ventilator supporting time, ICU stays, hospital stays and incidence of complications in the OPCABG group were significantly lower or shorter than those in the CCABG group (all P<0. 05). The scores of social function, mental function, general vi-tality, role emotional and general health of SF-36 questionnaire in the OPCABG group were significantly higher than those in the CCABG group (all P<0. 05), whereas there was no significant difference in the scores of bodily pain, physical function and role physical of SF-36 questionnaire between them (all P>0. 05). Conclusion Application of OPCABG in treatment of those elderly patients with CHD may have significant clinical efficacy, including such advantages as less surgical trauma, fewer postoperative complications and faster recovery, which would be helpful to improve their postoperative quality of life.