体外与非体外循环冠脉搭桥术临床对比研究及护理

Comparative study of clinical and unrsing care between conventional on-pump coronary artery bypass grafting and off-pump coronary artery bypass grafting.

目的对比研究体外循环冠状动脉搭桥术和非体外循环冠状动脉搭桥术的疗效。方法研究组57例采用非体外循环冠状动脉搭桥术;对照组15例体外循环冠状动脉搭桥术。比较两组手术时间、术中出血量、辅助呼吸时间、术后引流量、ICU监护时间、术后拔管时间、住院总天数、住院总费用等指标。结果研究组手术时间、术中出血量、辅助呼吸时间、术后引流量、ICU监护时间、术后拔管时间、术后住院时间、住院总费用等明显低于对照组（P〈0.05）。研究组术后无1例发生心绞痛,3例术后38h出现窦性心动过速,对照组7例术后24h出现心律紊乱,频发室早。其余恢复良好,均痊愈出院。随防6~36个月,研究组心绞痛消失,疗效满意;对照组术后2例13个月发生充血性心力衰竭,3例心律紊乱,频发室早。结论非体外循环冠状动脉搭桥安全、有效。非体外循环冠状动脉搭桥术比体外循环冠状动脉搭桥术术中心脏创伤小,术后心脏功能恢复快,并发症少,减少护理工作量,值得推广。

Objective To comparare the effects between conventional on-pump coronary artery bypass grafting and off-pump coronary artery bypass grafting.Methods Study group with 57 patients received conventional off-pump coronary artery bypass grafting and comparison group with 15 patients received conventional on-pump coronary artery bypass grafting.To compare the operative time、blood loss in operation、assist ventilation time、postoperative drainage、ICU care time、length of postoperative extubation time、total hospital days、hospital costs and other indicators between the two groups.Results The operative time、blood loss in operation、assist ventilation time、postoperative drainage、ICU care time、length of postoperative extubation time、total hospital days and hospital costs were significantly lower in study group than the comparison group（P0.05）.There were no one case of postoperative angina and three cases of sinus tachycardia occurred atter 38h in study group.And there were seven cases of postoperative arrhythmis and frequent PVCs after 24h.The remaining recovered well and were cured.Followed up for 6~36months,the anigina disappeared in the study group and received satisfactory effect.And there were 2cases with congestive heart failure and 3cases with arrhythmia and frequent PVCs in comparison group after 13 months.Conclusion Off-pump coronary artery bypass grafting is safe and effective.There is fewer cardiac trauma and complications,the heart recovers soon and the nursing work reduces compare with on-pump coronary artery bypass grafting.It is worth promoting.