非体外循环和体外循环冠状动脉旁路移植术桥流量变化的对比分析

Intraoperative Transit Time Flow Measurement:in Off-Pump Versus On-Pump Coronary Artery Bypass

目的:通过超声瞬间血流仪在术中测定体外和非体外循环冠状动脉旁路移植术患者血管桥流量和血流搏动指数变化,了解非体外循环冠状动脉旁路移植术血管桥吻合口的质量。方法:91例患者采用非体外循环方法(非体外组)行冠状动脉旁路移植术,同期有107例应用体外循环方法(体外组)行冠状动脉旁路移植术,测定两组间不同旁路移植术部位的血管桥流量和血流搏动指数变化。结果:冠状动脉旁路移植术两组间每个吻合口的平均血流量分别为(25.94±12.84)ml/min 和(30.29±11.42)ml/min(P<0.05);血流搏动指数分别为2.06±0.76和2.12±0.78(P>0.05)。除前降支和用大隐静脉为移植材料的对角支部位,体外组较非体外组冠状动脉桥的平均血流量明显增多(P 均<0.05)外;其余部位的平均血流量两组间无显著差异。两组间各部位总的血流搏动指数也无显著差异。结论:尽管非体外循环冠状动脉桥血流量偏低,但其血流搏动指数尚满意,说明术后早期吻合口质量可靠。

Objective：Transit time flow measurement is frequently used during coronary artery bypass with and without cardiopulmonary bypass to detect the quality of anastomosis in off-pump coronary artery bypass. Methods：Ninty one patients operated on using off-pump technique were included in the study. One hundred and seven patients operated on using on-pump technique. The mean flow and the pulsatile index were measured in every graft in both groups. Results：The average flow was 25.94 ± 12.84 ml/min and 30. 29 ± 11.42 ml/min （P 〈0, 05） and the average pulsatile index was 2.06 ± 0. 76 and 2. 12 ± 0.78 （ P 〉 0. 05 ） in both groups. Except left internal thoracic artery to anterior descending artery and diagonal territory which showed significantly lower mean flows in off-pump technique （ P 〈 0.05 ） , there were no differences in pulsatile index in both groups. Conclusion：The quality of anastomosis using off-pump coronary artery bypass technique might be reliable.