急性心肌梗死后非体外循环冠状动脉搭桥术临床研究

Clinical study on off-pump coronary artery bypass surgery for acute myocardial infarction

目的:探讨冠心病急性心肌梗死30 d内非体外循环冠状动脉搭桥手术的可行性和安全性。方法:回顾性分析130例急性心机梗死患者30 d内非体外循环冠状动脉搭桥术患者的临床资料,分析冠状动脉病变、冠状动脉搭桥支数、血液动力学参数、心肌损伤指标等因素的变化。结果:130例急性心机梗死患者30 d内非体外循环冠状动脉搭桥手术后死亡4例(3.1%),心力衰竭9例(6.9%),心律失常20例(15.4%)。结论:急性心肌梗死30 d内冠状动脉搭桥手术具有可行性和安全性,但术前肌钙蛋白I应尽量接近或达到正常,急性期手术其术后并发症发生率高于非急性期手术。

Objective To discuss the feasibility and efficacy of off-pump coronary artery bypass for acute myocardial infarction within 30 days.Methods One hundred and thirty patients with acute myocardial infarction（within 30 days） underwent the off-pump coronary artery bypass surgery were retrospectively reviewed.The data of coronary artery lesions,coronary artery bypass grafts,postoperative serum tests,hemodynamic parameters,and myocardial injury indicators were analyzed.Results In 130 patients,4 patients（3.1%） died,heart failure occurred in 9 patients（6.9%）,and arrhythmia occurred in 20 patients（15.4%）.Conclusion It＇s safe and feasible to perform off-pump coronary artery bypass surgery for acute myocardial infarction,but cTn I level is required to be normal or reach the normal index before operation.The complication rate of surgery in acute stage is higher than that in non-acute stage.