心脏不停跳冠状动脉搭桥术在老年人中应用的临床效果观察

目的探讨心脏不停跳冠状动脉搭桥术在老年人中的应用.方法通过对89例60岁以上老年患者施行了不停跳冠状动脉搭桥术（OPCAB）,与同期80例行体外循环下的冠脉搭桥术（CPB）老年患者进行术前术后一般状况的对比.结果 OPCAB组平均年龄、术前肌酐高于正常的比例、术前有脑梗死史的比例显著高于CPB组.OPCAB组患者手术死亡率显著低于CPB组（1.12%VS5.00%）,术后房颤发生率也显著低于CPB组（5.61%VS11.2%）.结论 OPCAB在老年患者中应用,尤其对于术前有肾功能异常、呼吸系统疾病、中枢神经系统疾病及严重动脉硬化的老年患者,能够获得更多的手术治疗机会和良好的临床效果.

Application of Off-pump Coronary Artery Bypass Grafting in the Elderly Patients

Objective To explore the application of off-pump coronary artery bypass grafting（CABG） in the elderly patients.Methods A retrospective review was carried out for 89 patients over 60 years who underwent isolated off-pump and on-pump CABG in The First Affiliated Hospital of Kunming Medical University between October 2005 and May 2009.We studied in detail their preoperatie and postoperatie data in order to compare the outcomes of both groups.Results The mean age,the proportion of patients with preoperative serum creatinine over the normal levels and the history of cerebral infarction were higher in off-pump group than in on-pump group.The frequency of hospital death was significantly fewer in off-pump group than in on-pump group（1.12% v5.00%）.The frequency of postoperative atrial fibrillation was significantly fewer in off-pump group than in on-pump group（5.61%V 11.2%）.Conclusions Off-pump CABG is safe and effective for the elderly patients.Off-pump CABG successfully reduces the incidence of postoperative death in the elderly patients with renal dysfunction,respiratory failure and cerebral vascular accident