非体外循环冠状动脉旁路移植术的总结(附105例分析)

目的:总结105例非体外循环下(off—pump)冠状动脉旁路移植术的经验。方法:105例患者中男87例,女18例。年龄48～74(平均59.l±9.06)岁。手术在全麻常温下进行,正中切口。单支病变18例,双支病变20例,三支病变62例,左主干病变15例;急性心梗1例,陈旧性心梗3例。搭1支桥8例,搭2支桥26例,搭3支桥43例,搭4支桥22例,搭5支桥6例,内膜剥脱1例。平均每例搭桥2.9支。结果:全组无手术死亡,平均带气管插管时间10.9±10.78小时,平均在ICU45.9小时。术后平均胸腔引流量394 ml,术后1例1年内经冠脉造影提示血管桥堵塞。结论:非体外循环下的冠状动脉旁路移植术是安全可行的;适用于左主干病变,三支病变及心梗患者;可以做到完全再血管化,对于冠心病患者应为首选。

Experience of off-pump coronary artery bypass grafting in 105 patients

Objective: To analysis the clinical results of off-pump coronary artery bypass grafting in 105 patients. Methods: From March 2000 to November 2001, 105 consecutive patients underwent off-pump coronary artery bypass grafting (CABG). The age ranged 48-74 years with a mean of 59 years. Sixty-two patients had three-vessel disease, 20 patients had two-vessel disease and 18 patients had single vessel disease. Access was through a standard median sternotomy incision in 105 patients. Results: All patients survived, operation were followed up 1 - 36 months. One patient was showed bypass artery occlusion by coronary arteriography after operation 1 year. Conclusion: Off-pump CABG may regards as first alternative treatment of CABG for coronary diseases its early result is satisfactory.