非体外循环冠状动脉搭桥术

目的报告微创非体外循环冠状动脉搭桥术(OPCAB)的临床应用和初步体会.方法25例冠心病患者(男23例,女2例;年龄52～75岁,平均63.2岁)中三支病变19例,双支病变4例,左主干病变2例.均在全麻常温下经胸骨正中切口行OPCAB,人均搭桥3.32支.联合应用左乳内动脉和大隐静脉20例,全动脉化搭桥3例,序贯式搭桥16例.结果全组手术均顺利进行,无手术死亡.术后平均呼吸机辅助时间6.2 h,8例病人(31%)未输血,术后患者心绞痛症状均消失,心功能改善.结论OPCAB安全、经济、有效,是一种值得推广的微创心脏手术方法.

Off-pump Coronary Artery Bypass Grafting Without Stopping of Heartbeating

Objective:To report the clinical application and the preliminary experience of off pump coronary artery bypass (OPCAB) grafting with minimal incisions. Method: 25 patients with coronary heart diseases (23 male, and 2 female; the ages ranging from 52 to 75 with an average of 63.2 ), among whom 19 patients had three vessel diseases, 4 had two vessel diseases and one had a disease in the left major vessel.They underwent OPCAB under general anesthesia, with an average of 3.32 bypasses per patient. Access was through left breast interior artery and the great saphenous vein in 20 patients; thorough artery bypasses in 3 patients (1 through interior artery on either side of the breast, 2 through left breast interior artery and artery); and through sequential bypasses in 16 patients. Results: All the patients underwent snccessful surgeries with no surgical mortalities.The average time of the help of respiration machine after surgery is 6.2 hours. 8 patients needed no blood transfusion. Average cost for hospitalization is 38,000 yuan. They were all free of angina pectoris and showed cardiac improvements. Conclusion: OPCAB is a safe, economical and effective cardiac surgical method with minimal incisions which is worthy of popularization.