老年冠心病人的非体外循环下冠状动脉旁路移植术

Effect of off-pump coronary artery bypass grafting in the aged with coronary artery disease

目的:探讨老年(70岁及以上)人冠心病患者非体外循环下冠状动脉旁路移植术(OPCABG)的可行性和优越性。方法:回顾性分析207例老年(70岁及以上)冠心病患者的冠状动脉旁路移植术资料。其中OPCABG组146例,占70.5%;体外循环下冠状动脉旁路移植术(CCABG)组61例(29.5%)。比较两组术后早期死亡率及合并症的发生情况。结果:OPCABG组平均搭桥(3.58±1.03)支/人,CCABG组平均搭桥(3.45±1.28)支/人,两组无明显差别。OPCABG组术后早期死亡率显著低于CCABG组(1.4%∶8.2%,P<0.01)。与CCABG组比较,OPCABG组的术后平均气管插管时间、平均ICU停留时间、平均输血量、二次开胸、神经系统并发症明显减少(P均<0.01)。结论:非体外循环下冠状动脉旁路移植术在老年冠心病患者中安全可行,临床效果好。

Objective： To analyze the feasibility and the superiority of off-pump coronary artery bypass grafting （OP- CABG） in the aged （≥70 years of age） with coronary artery disease （CAD）. Methods： A retrospective study was carried out review experience. A total of 207 aged CAD cases underwent CABG were divided to two groups： OPCABG group [underwent OPCABG, 146 cases （70. 5%） ] and CCABG group [underwent CCABG, 61 cases （29.5%）]. The early post-operative mortality and complications of two groups were compared. Results： The number of bypass grafts was （3. 58±1.03） branchs/man in OPCABG group and （3.45±1.28） branchs/man in CCABG group （P〉 0.05）. The early post-operative mortality of OPCABG group was significantly lower than that of CCABG group, （1.4% ： 8.2%, P〈0.01）. The time of intubation, ICU-stay, volume of transfusion, re-open and complication of central nervous system of OPCABG group were significantly less than those of CCABG group （P〈0.01 all）. Conclusion： It is safe and effective to perform OPCABG in the aged with coronary artery disease.