395例体外循环下冠状动脉旁路移植术临床分析

On-pump coronary artery bypass grafting:a report of 350 cases

目的：总结分析冠状动脉旁路移植术（ CABG）治疗冠心病的疗效和经验。方法2002年1月至2012年12月我们完成CABG有395例,其中男299例,女96例,平均年龄62.3岁,均在中低温体外循环下完成手术,其中18例同期行室壁瘤切除术。结果本组平均搭桥3.2支。体外循环时间62-170 min,平均88 min,主动脉阻断时间25-102 min,平均68 min。术后机械通气时间12-72 h,平均18 h。围手术期死亡8例,死亡率2.0%,其中多器官功能衰竭6例,术后发生室颤抢救无效死亡1例,围术期急性心肌梗死1例。心功能均明显改善,195例心绞痛症状完全缓解,85例症状较前减轻。随访280例,随访时间8个月至11年,远期死亡5例,死亡原因不明。结论常规中低温体外循环下CABG是治疗冠心病安全、有效的方法。

Objective To summarize the clinical experiences of coronary artery bypass grafting （ CABG） in the treatment of coronary artery disease. Methods CABG were performed on 395 consecutive cases from January 2002 to December 2012,including 299 male and 96 female with a mean age of 62. 3 years old. All the operation were performed under cardiopulmonary bypass （CPB ） with moderate hypothermi-a. Left ventricular aneurysm plasty operation were performed in 18 patients. Results The mean number of grafts was 3. 2,the mean CPB time was 88 min（ 62-170 min） ,aortic cross-clamping time was 68 min（ 25-102 min） ,mean ventilation time was 18 h（ 12-72 h） . There were 8 deaths with a mortality of 2. 0%. Six patients died of multiple organ failure,1 patients died of ventricular fibrillation after operation,1 patients died of acute myocardial infarction. Postoperative follow up was carried out on 280 cases,follow-up time was from 8 months to 11 years. Five of them died of unknow causes. The heart function of the rest was significantly improved. 195 patients were free of angina. 85 pa-tients’ s symptom got better. Conclusion CABG performed under cardiopulmonary bypass （ CPB ） with moderate hypothermia is safe and effective for the treatment of coronary artery disease.