非体外循环冠状动脉旁路移植术160例临床分析

Clinical analysis of off- pump coronary artery bypass grafting： A report of 160 consecutive cases

目的分析非体外循环下冠状动脉旁路移植（OPCAB）手术方法及初步临床结果。方法自2002年3月～2006年3月共完成160例OPCAB，其中左主干病变19例，单支、双支和三支病变分别为8例、30例和122例。158例经正中切口，2例经左前外切口行OPCAB人均旁路移植3．4支（1～5支）。应用左乳内动脉159例。余为大隐静脉。结果全组无住院死亡。平均呼吸机辅助时间7小时。胸腔引流液（270±80）ml，二次开胸1例。结论非体外循环下冠状动脉旁路移植术对冠状动脉疾病患者是一种安全、可行、有效的术式。

Objective To evaluate the technique of off- pump coronary bypass gtafting and its early result in 160 consecutive patients. Methods One hundred and sixty patients underwent minimal invasive coronary artery bypass grafting on the beating heart without cardiopulmonary bypass through median sternotomy between Mar. 2002 and Mar . 2006. The average unmber of grafts was 3.4. One hundred and fifty - nine patients had left internal mammary artery bypassed to the left anterior descending branch. Other grafts were from saphenous veins. Results All patiens were clinical recovery. Respirator assisted within 0 -18 hours （average 7 ）. ter average chest drainage was （270 ± 80）ml. Conclusion Off - pump coronary artery bypass can be safely done with low mortality excellent surgical results even in patients with multi - vessel coronary ar- tery disease.