冠状动脉旁路移植术8例临床分析

Coronary Artery Bypass Grafting: A Clinical Analysis of 8 Consecutive patients

１９９４年５月１９９５年１０月间，澳门镜湖医院心血管外科连续进行了冠状动脉旁路移植（搭桥）术８例。其中男性７例，女性１例，年龄６０至７９．５岁，平均６８．２岁。术的心功能Ⅱ至Ⅲ级（其中１例术前２月曾发生急性心肌梗塞，心跳骤停）。本组病例术前均行冠状动脉造影证实诊断。术中共搭桥２４根，平均每例３根。包括利用大隐静脉２３根，其中以序贯式吻合１很；利用左内乳动脉１根。术后出现严重低心排和出血性心包填塞共２例，经抢救成功，８例均痊愈。本文就（１）高龄病人接受冠状动脉搭桥手术；（２）术中心肌保护；（３）术后复苏处理；（４）ＩＡＢＰ在术中术后低排治疗的应用等问题进行了讨论。

From May 1994 to Oct. 1995, coronary artery bypass grafting was pelformed on 8 consecutive patients in Kiang Wu Hospital, Macao. Among them, 7 were males and 1 was female. Ages of the patients ranged from 60 to 79. 5 (mean 68. 2) years old. All teh patients were in heart function Ⅱor Ⅲ (NYHA), and one of them had had cardiac arrest caused by AMI before operation. The total number of grafts used were 24 with an average of total number of grafts used wer 24 with an average of total number of grafts used were 24 with an average of 3 per patient. 23 grafts were removed from SV and 1 form LIMA.One of the patients suffered from serious low cardiac output and another suffered from acute cardiac tamponade post-operatively. However both of them recovered. The following questions were discussed: (1 ) CABG in elderly patients. (2 ) Myocardiac protection, (3 ) Management in early post-operative recovery, and (4) Application of IABP to treat lOw cardiac output.