微创采集大隐静脉对冠脉搭桥病人呼吸循环功能的影响

Effects of harvesting great saphenous vein through endoscope on function of respiration and circulation

目的:探讨经内窥镜采集大隐静脉技术对呼吸循环功能的影响。方法:冠状动脉搭桥手术(CABG)40例,采集大隐静脉随机分为经开放切口(OVH)组和应用内窥镜(EVH)组。测定并比较两组采集过程中的循环动力学及血气指标。结果:两组各时点心率、平均动脉压无统计学差异;EVH组随CO2气体充填时间延长,二氧化碳分压、呼气末CO2分压、乳酸浓度进行性升高,与OVH组取血管过程中的相比差异有显著性(P<0.05)。结论:EVH组循环指标能够维持稳定,应防范高碳酸血症对氧供需平衡的不良影响。

Objective： To investigate the effects on function of respiration and circulation by technique of harvesting great saphenous vein through endoscope. Methods： Great saphenous vein were harvested in 40 patients with coronary artery bypass surgery. The patients were randomly divided into 2 groups： open vein harvesting （OVH） group and endoscope vein harvesting （EVH） group. Index of circulatory kinetics and blood gas during the vein harvest process were determined and compared. Results： The value of HR. MAP between two groups at each time point have no statistical disparity; the value of blood PaCO2, PerCO2, Lac level in EVH group become higher and higher following the elongation of carbon dioxide filling time, and were more than those of OVH group （P〈0.05）. Conclusion： Index of circulation in EVH group can maintain stable, but should guard against harmful effects on supply and demand equilibrium of oxygen by hypercapnia.