冠状动脉旁路移植术209例临床疗效分析

目的:探讨体外与非体外循环冠状动脉旁路移植术治疗冠心病患者的临床疗效。方法:对209例冠心病患者行冠状动脉旁路移植术,选择性冠状动脉造影检查显示:1支病变9例,2支病变17例,3支以上病变183例。行体外循环下冠状动脉旁路移植术86例,非体外循环下冠状动脉旁路移植术123例。结果:本组共移植血管668支,每例患者移植血管1～8支,平均3.20支。应用主动脉球囊反搏9例;术后呼吸机辅助时间3～98h,平均7.6h。手术死亡6例,病死率为2.91。死于低心排血量综合征3例,多脏器功能衰竭2例,呼吸衰竭1例。203例患者出院时症状明显改善及消失。随访115例(56.56)。随访时间2个月至5.1年,心绞痛消失109例,复发6例。结论:综合患者的病情特点及医疗条件,人文地决定相应的手术方式;结合病人的年龄恰当选择旁路移植血管;均可优化冠状动脉旁路移植术的效果。对改善和提高冠心病患者生活质量有着重要的作用。

The outcomes of coronary artery bypass grafting in 209 cases

Objective：To compare of off-pump coronary artery bypass grafting and on-pump coronary artery bypass grafting for patients with coronary artery diseases and to provide new theoretical gist for preventing it. Methods：Coronary artery bypass grafting （CABG） were performed from January 2005 to December 2009 on 209 cases in our department.including 163 male and 46 female with a mean age of 65.6 years（range,35.0-82.0）.Coronary angiography revealed single vessel disease in 9 cases,2branchs vessel disease in 17 cases,3 and over branchs vessel disease in 183 cases.On-pump CABG were performed on 86 cases and 123 cases received off-pump CABG.Results：A total number of 668 grafts（range,1-8 grafts,mean,3.2grafts/case）.Intro aortic balloon pump support were provided to 9 patients.Postoperative ventilation duration varied from 3-98 hours,average was 7.6 hours. There were 6 cases to deaths with a mortality of 2.91,For 3 cases had low cardiac output syndrome,2cases had multiorgan failure and 1 case had respiratory failure.Upon discharge from the hospital,203 patients were free from angina.Postoperative follow up was carried out on 115 cases（56.56）for a period of 2month to 5.1 years,109 cases were free from angina and 6 cases had recurrent angina. Conclusion： Good results of coronary artery bypass grafting could be achieved with careful analysis of state of an illness and medical condition, to decide homologous modus operandi.Meantime to combine together patients of age to choose vessel.CABG is important to cure and improve living capacity patients of coronary arterial disease.