合并慢性阻塞性肺病的冠心病患者不停跳搭桥疗效分析

THE CLINIC OUTCOMES OF OFF-PUMP CORONARY ARTERY GRAFT BYPASS ON THE PATIENTS WITH CORONARY ARTERY DISEASE AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE

目的评价同时合并慢性阻塞性肺病的冠心病患者不停跳搭桥手术的临床效果。方法回顾性总结本院18例接受不停跳冠状动脉搭桥术的合并慢性阻塞性肺病冠心病患者的临床资料,和同期接受体外循环下冠脉搭桥手术的这类病人进行比较。结果无手术相关死亡,1例术后14d死于呼吸衰竭,常规体外循环下冠脉搭桥组较不停跳冠脉搭桥组有较多的呼吸系统并发症,在术中常规搭桥组的PaO2 /FiO2 由于心肺转流而高于不停跳搭桥组,在术后6～12h却低于不停跳搭桥组。结论不停跳冠脉搭桥术由于较小地损伤肺的交换功能和较低的肺部并发症而更适合合并慢阻肺的冠心病患者。

Objective To evaluate the clinical outcomes of off-pump coronary bypass on patients with coronary disease as well as chronic obstructive pulmonary disease. Method The data of 18 patients with two diseases received off-pump coronary bypass operation were summarized respectively, compared with the cases received on-pump coronary bypass at the same time. Result No operation-related death. Only one died of respiratory failure 14 days after the operation in hospital. There was more respiratory complication in conventional coronary artery bypass grafting group (CCABG) than off-pump coronary bypass grafting group(OPCABG), and PaO_2/FiO_2 in CCABG was higher than that in OPCABG among operation because of CPB, but lower than that in OPCABG at post-operative 6～12 hours. Conclusion OPCABG seems more suitable than CCABG in coronary patients with chronic obstructive pulmonary disease due to less damage on oxygen-exchange capability and less respiratory complication.