70岁以上老年患者冠状动脉旁路移植手术的临床观察

目的：分析我院70岁以上老年患者冠状动脉旁路移植手术的临床特点。方法收集70岁以上老年患者冠状动脉旁路移植手术共232例病例资料进行分析，其中行单纯冠状动脉旁路移植手术208例，加做二尖瓣置换或二尖瓣瓣环成形手术11例，加做主动脉瓣置换手术6例，加做二尖瓣及主动脉瓣双瓣膜置换手术1例，加做纵隔或心包肿物切除手术5例，加做室壁瘤切除手术1例。结果手术后出现呼吸功能衰竭8例、伤口愈合不良6例、手术后出血行二次开胸止血4例，围手术期心肌梗死2例、Ⅲ度房室传导阻滞1例，心包填塞1例。死亡2例。结论70岁以上老年患者行冠状动脉旁路移植手术总体效果满意，手术可提高患者生活质量，延长生存时间。

Clinical observation of coronary artery bypass graft surgery for elderly patients over the age of 70 years

Objective To analyze the clinical characteristics of coronary artery bypass graft sur-gery for elderly patients over the age of 70 years. Methods The clinical data of 232 elderly patients （ age﹥70 years）who underwent coronary artery bypass graft surgery were collected for analysis,including 208 cases of simple coronary artery bypass graft surgery,11 cases of additional mitral valve replacement or annuloplasty,6 cases of additional aortic valve replacement,1 case of additional mitral and aortic valve re-placement,5 cases of additional mediastinal or pericardial tumor resection and 1 case of additional aneu-rysm resection. Results There were eight cases of postoperative respiratory failure,six cases of poor wound healing,4 cases of secondary exploration for postoperative bleeding,2 cases of perioperative myocar-dial infarction,1case of third-degree atrioventricular block and 1 cases of cardiac tamponade. Deaths oc-curred in 2 cases. Conclusion For elderly patients over the age of 70 years,overall effect of coronary ar-tery bypass graft surgery is satisfied. It can improve the quality of life and prolong survival time.