非体外循环冠状动脉旁路移植术治疗冠状动脉粥样硬化性心脏病的体会

目的：总结非体外循环冠状动脉旁路移植术治疗冠状动脉粥样硬化性心脏病的疗效及围术期处理方法。方法：对63例冠状动脉粥样硬化性心脏病患者采用非体外循环冠状动脉旁路移植术治疗;患者冠状动脉旁路移植1～4支[（2.2±0.9）支]。非体外循环手术时间为2.0～5 h[（3.6±1.2）h];术中无改行体外循环冠状动脉旁路移植术,手术成功率100%,无手术死亡。结果：术后早期死亡2例,死亡原因为多器官功能衰竭,其余患者术后心绞痛、胸闷、气短等均有明显缓解,心肌缺血明显改善,随访6～60个月,均恢复良好,心功能Ⅰ～Ⅱ级。结论：非体外循环冠状动脉旁路移植术安全有效,严格掌握手术指证、熟练的外科手术技巧、妥善细致的围手术期处理,是提高手术成功率的关键。

The extracorporeal circulation of coronary artery bypass transplantation in treatment of coronary atherosclerotic heart disease

Objective： To summarize the extracorporeal circulation of coronary artery bypass grafting in treatment of coronary atherosclerosis heart disease curative effect and perioperative experience. Methods： Sixty- three cases of coronary atherosclerosis sex heart disease were treated by extracorporeal circulation of coronary artery bypass grafting treatment; 1 ～ 4 in patients with coronary artery bypass grafts,the average（ 2. 2 ± 0. 9）. The extracorporeal circulation operation time 2. 0 ～ 5 hours,the average（ 3. 6 ± 1. 2） hours. Intraoperative without switching extracorporeal circulation of coronary artery bypass grafting,die without surgery,the success rate of 100%. Results： Early postoperative death in 2 cases,the cause of death for multiple organ failure,and the rest of the postoperative patients with angina,chest tightness,shortness of breath,etc all have significant relief,myocardial ischemia improved significantly,and were followed up for 6 ～ 60 months,all recovered well,cardiac function grade Ⅰ ～ Ⅱ. Conclusion： Extracorporeal circulation of coronary artery bypass grafting is safe and effective,strictly grasp the operation indication,skillful surgical technique and proper careful perioperative management,the key is to improve the success rate of extracorporeal circulation of coronary artery bypass transplantation surgery.