冠心病合并甲状腺功能减退症的冠状动脉旁路移植术治疗

Treatment of coronary heart disease and hypothyroidism with coronary bypass surgery

目的探讨冠状动脉粥样硬化性心脏病合并甲状腺功能减退症冠状动脉旁路移植术治疗的临床效果和围手术期处理策略。方法回顾性分析2006年1月-2009年9月11例冠状动脉粥样硬化性心脏病合并甲状腺功能减退症(甲减)患者行冠脉搭桥术临床资料。结果术中搭桥血管数为2-4(2.96±0.51)根,监护室停留时间与气管插管时间分别为(50.2±11.6)h和(14.5±6.9)h。术后2例患者因低心排而再次气管插管。平均随访6-39(24.5±16.7)月,均存活。结论冠状动脉旁路移植术是治疗冠心病合并甲减患者的较好方法,早期适当甲状腺激素替代治疗对防止术后并发症、降低手术风险十分必要。

Objective To study the effect of coronary artery bypass grafting（CABG） on coronary heart disease and hypothyroidism and the management strategies during pre-operation.Methods Clinic data about 11 patients who underwent CABG for coronary heart disease and hypothyroidism from January 2006 to September 2009 were retrospectively analyzed.Results The number of bypassed blood vessels was 2-4（2.96±0.51）.The stay time in ICU and the time of tracheal intubation were 50.2±11.6h and 14.5± 6.9h,respectively.Two patients underwent a second tracheal intubation due to low cardiac output.The patients were followed up for an average time of 24.5±16.7 months with a 100% survival rate.Conclusion CABG is a rather good procedure for coronary heart disease accompanying hypothyroidism.Early and appropriate thyoid replacement therapy can prevent the complications and risk of CABG.