冠状动脉旁路移植术后桡动脉桥血管通畅率的影响因素分析

目的 分析冠状动脉旁路移植术(CABG)后桡动脉(RA)桥通畅率的影响因素。 方法 回顾性分析在CABG术中使用RA桥,并于术后1年复查冠状动脉计算机断层扫描血管造影术(CTA)患者65例。收集患者术前、术中及术后的相关资料,采用多因素logistic回归分析筛选RA桥通畅率的影响因素。 结果 RA桥靶血管近端狭窄程度≥80%(OR=0.212, 95%CI: 0.049~0.912, P=0.037)和靶血管在左前降支区域(OR=0.104, 95%CI: 0.012~0.921, P=0.042)是RA桥术后通畅率的独立保护因素,而术后未规范联用抗痉挛药物(OR=6.825, 95%CI: 1.857~25.083, P=0.004)是RA桥通畅率的独立危险因素。 结论 CABG术中RA桥靶血管的合理选择和术后联用抗痉挛药物是RA桥通畅率的独立影响因素。

Influencing factors for the graft patency of radial artery after coronary artery bypass grafting surgery

Objective To analyze the influencing factors for the graft patency of radial artery(RA)after coronary artery bypass grafting(CABG). Methods Clinical data of 65 patients who adopted RA grafts in isolated CABG and underwent computed tomography angiography one year after operation were retrospectively analyzed, including preoperative, intraoperative and postoperative data. Multiple logistic regression analysis was performed to explore the influencing factors for RA graft patency. Results Native stenosis of target vessel ≥80%(OR=0.212, 95%CI: 0.049-0.912, P=0.037), and target vessel in the left anterior descending artery territory(OR=0.104, 95%CI: 0.012-0.921, P=0.042)were independent protective factors for RA graft patency, while non-adherence to the postoperative combination of anti-spastic medications(OR=6.825, 95%CI: 1.857-25.083, P=0.004)was an independent risk factor. Conclusion Proper choice of target vessels during the operation and combination of anti-spastic medications after operation are independent influencing factors for RA graft patency.