体外循环与非体外循环冠脉搭桥手术早期预后的比较

Comparision of early outcome between on-pump and off-pump coronary artery bypass grafting

目的:通过对体外循环下(on-pump)和非体外循环下(off-pump)冠状动脉搭桥手术进行回顾性调查,比较两种手术方法的早期预后效果。方法:从我院2005年1月～2008年6月择期进行的346例冠脉搭桥手术中选择291分为非体外循环组(off-pump组,189例?和体外循环组(on-pump组,102例),对两组的术前基本特征,麻醉药用量,手术时间,ICU停留时间,术后带管时间,输血量以及住院费用、苏醒时间等情况进行分析。结果:两组病人的术前资料基本相似,与off-pump组相比,on-pump组的异体输血量[(4.49±2.56)u]、住院费用[(54808.41±2101.52)元]、手术时间[(5.04±1.12)h]、苏醒时间[(183±49)min]均高于off-pump组。on-pump组术后呼吸功能异常的比例更高,两组间差异有统计学意义(P<0.05)。两组围术期病死率、住院时间及术后机械通气时间相似,差异无统计学意义(P>0.05)。结论:非体外循环冠脉搭桥手术与体外循环下冠脉搭桥手术一样安全,与on-pumpCABG相比,off-pumpCABG术后并发症发生率更低,并且住院费用更低,值得进一步推广。

Objective： To systemically compare the early outcome between on pump and off-pump coronary artery bypass graftirg （CABG）. Methods： Retrospective database and medical record review from January 2005 to June 2008,189 consecutive patients enrolled in the off-pump CABG were compared with 102 consecutive on-pump patients from the first affiliated hospital of Xin Jiang Medical University. Preoperative characteristics, allogeneic blood transfusion, operation time, cost of initial hospitalization, preoperative and postoperative complications were compared in the two groups. Results： Preoperative characteristics were similar in both groups. Compared with the off pump group, allogeneic blood transfusion [（4.49 ± 2.56） u], the operation time [（5.04±1.12） h], the cost of initial hospitalization [（5 4808.41±2 101.52） yuan], recovery time [（183± 49） mini of on pump group were higher than the off-pump group. The differences of the two groups were significant （P〈0.05）. The perioperative motality , the time of hospitalization, the time of ventilation was similar in the two groups. The differences of the two groups had no statistical significance （P 〉0.05）. Conclusions： Off-pump coronary artery graft surgery （OPCABG） is as safe as on-pump CABG, The incidence of perioperative complications in off-pump group is significantly lesser than that in on-pump group, and the cost of initial hospitalization in off-pump CABG is cheaper than on-pump CABG. It suggests that off pump CABG should be developed.