冠状动脉旁路移植术治疗冠心病的临床应用研究

A clinic study of coronary artery disease undergoing coronary artery bypass grafting

目的报告冠状动脉旁路移植手术(CABG)治疗冠心病的早期结果及分析。方法对270例冠心病患者行冠状动脉旁路移植手术,应用体外循环(ONCABG)63例,非体外循环(OPCABG)207例;不稳定型心绞痛130例,陈旧性心肌梗死96例,室壁瘤15例;多支病变188例,二支病变61,左主干病变21例:合并糖尿病86例,高血压91例,瓣膜病32例,均于术中同期手术处理。结果手术平均每例搭桥3.16支,术后需用IABP支持治疗8例,无围手术期心肌梗死。早期死亡1例;患者术后心绞痛症状消失,生活质量明显提高。结论 CABG手术治疗冠心病临床效果好,充分的术前准备,熟练的手术技术是手术成功的关键:对高龄、多支病变、陈旧心梗并发症及心功能较差的患者仍具有良好的安全性。

Objectives To report and analyze the early surgical outcomes and clinical experience of patients with coronary disease undergone coronary artery bypass grafting（CABG）.Methods Two hundred and seventy patients undergone CABG were reviewed.Including 60 cases on-pump CABG,207 CASES of-pump CABG.The patients were 130 cases with unstable angina syndrome,96 cases with old myocardial infarction.15 cases with heart aneurysm. Coronary angiography revealed that there were 188 patients with triple-vessel disease,61 with double-vessel disease,21 with left major vessel disease.There were 86 patients with diabetic disease,91 with hypertension,32 with cardiac valve disease.All the patients received combined surgery treatment in one time. Results The numbers of grafts were mean 3.16 /case.After operation,introaortic balloon pump support was provided to 8 patients.There was no patient with peri-operative myocardial infraction.One case died in post-operation early.All the patients have no angina syndrome and have improved quality of live. Conclusion CABG surgery for coronary artery disease can achieve a satisfied early clinical outcome.Sufficient ready of pre-operative and excellent surgical techniques is the important key to ensure the operative success.CABG surgery is a safe and feasible procedure for old patient,multila-vessels disease,old myocardial infraction,and lower cardio-function patients.