146例重症冠心病的体外循环下冠状动脉旁路移植术

Pump coronary artery bypass grafting of severe coronary artery disease

目的:探讨如何提高重症冠心病人体外循环下冠状动脉旁路移植术的手术疗效。方法:回顾性分析146例重症冠心病的体外循环下冠状动脉旁路移植术的临床资料。男性95例,女性51例;搭桥数3～6(4.21±0.89)支/人。对手术方法、主要并发症和术后处理进行分析总结。结果:2次开胸2例(1.4%),低心排综合征6例(4.1%),应用IABP 6例(4.1%),反复发作房颤12例(8.2%),肺功能不全8例(5.5%),死亡1例(0.7%),其余患者康复出院。结论:合理地选择患者,成熟的手术技术,主动脉内球囊反搏(IABP)的尽早应用及术后处理的加强是提高重症冠心病人体外循环下冠状动脉旁路移植术疗效的重要措施。

Objective ：To investigate the method of improving the results of pump coronary artery bypass grafting （PCAB） for the patients with severe coronary artery disease. Methods： A retrospective study was carried out to review the experience. 146 cases with severe coronary artery disease underwent PCAB, 95 males and 56 females were enrolled. 3 ～ 6 grafts were transplanted to patient, mean （4.21± 0.89）. Surgical technique, complications and post - operative treatment were analyzed. Results： Early post - operative complication included： Re - open in 2（ 1.04% ）, LCOS in 6（4.1% ）, IABP was used in 6 （4.1%）, repeatedly a trial fibrillation in 12（8.2% ）, respiratory insufficiency in 8（5.5% ） and death in 1 （0.7%）. The others had favorable outcomes. Conclusions： Suitable disease, exceUent surgical technique, IABP applied early and enhancing post - operative treatment can significantly improve the results of PCAB for the patients with severe coronary artery disease.