冠状动脉搭桥术早期并发症及死亡率(附196例报告)

EARLY POSTOPERATIVE COMPLICATIONS AND MORTLITY OF CORONARY ARTERY BYPASS GRAFT IN 196 PATIENTS

1985年1月～1987年12月作者于荷兰格罗宁根医学科学院心胸外科主做了196例冠状动脉搭桥术。术后早期死亡2例(1.0％)、内出血3例(1.5％)、胸骨裂开2例(1.0％)、心律紊乱40例(20.4％)、围手术期心肌梗塞5例(2.6％),本文就术后早期并发症进行了讨论。

Results of one hundred and ninety six patients undergone coronary artery bypass graft from Jan. 1985 to Oct. 1987 in University Hospital Groningen,Netherlands, by the first author are presented. The patients' age ranged from 39 to 79 years old. 69 (35.2％)patients were older than 65 years old. 22(11.2％)patients had one vessel diseas;63(32.2％)patients two vessel disease;and 111(56.6％)patients three vessel disease. Among them, 51(26％)patients had stable angina and 145(74％)patients had unstable angina. Acording to NYHA classification, 2(1.0％)patients were Class Ⅰ;26(13.3％)Class Ⅱ;79(40.3％)Class Ⅲ and 92(16.9％)Class Ⅳ. Saphenous vein bypass graft was performed in 181 patients and either only left internal mammary artery graftor combined with saphenous vein graft were performed in 15 patients. There were 750 coronaty grafts performed(3.8 grafts per patient). Associated operations included aortic valve replacement(1) ,endarterectomy(5)and debridging operation(1). Postoperative complications included reexploration for bleeding in 3(1.5％)patients,sternal dehiscence in 2(1.0％)patients, perioperative myocardial infarction in 5(2.6％)patients and arrythmia in 40(20.4％)patients. The mortality rate was 1.0％(2 patients). Coronay artery bypass graft is a kind of safe operation with low mortality and includence of complications.