80岁以上高龄患者冠状动脉旁路手术63例报告

目的:探讨80岁以上高龄患者冠状动脉旁路手术治疗冠心病。方法:连续63例80岁以上高龄冠心病患者在体外循环(CPB)和非CPB下行冠状动脉旁路手术。结果:全组患者无手术死亡。术后并发症有心房纤颤、液气胸、胸骨感染、肾功能衰竭及呼吸功能不全等,均经积极治疗痊愈。不停跳冠状动脉旁路移植术(OPCAB)组患者危重并发症发生率显著低于CPB下手术者(P<0.02)结论:只要术前准备充分,手术方法精确,术后积极处理并发症,80岁以上高龄患者行冠状动脉旁路手术是安全可行的。

A report of 63 cases of CABG in patients of age older than 80 years

Objective： To discuss CABG in patients of age older than 80 years. Method： CABG on patients with or without extracorporeal circulation. Result：There were not operative deaths. Postoperative complications were atrial fibrillation, heamothorax, pneumothorax, sternum infection, renal failure, ARDS etc. All complications were cured. Severe postoperative complications in OPCAB patients were significantly lower than that in patients of CABG with CPB（P 〈 0.02）. Postoperative stay in hospital of OPCAB patients was significantly shorter than that of CPB patients （ P 〈 0.05）. More atrial fibrillation were found in OPCAB patients than that in CBP patients （ P 〈 0.01 ）. In CBP patients, more complications were found in arrested heart patients than that in beating heart patients （ P 〈 0.05）. Concluslon：It is safe to perform CABG on patients of age older than 80 years if there are good preoperative preparation, accurate operation and active treatment df postoperative complications.