非体外循环下行冠脉搭桥手术对患者心肺功能的影响

Influence of off-pump coronary artery bypass on heart and lung function of patients

目的探讨非体外循环下行冠脉搭桥手术对患者心肺功能的影响。方法206例拟行冠脉搭桥术的患者按照数字表法随机分为两组，观察组103例，对照组103例，观察组采用非体外循环下行冠脉搭桥手术，对照组采用体外循环下行冠脉搭桥手术。测定两组患者的左室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、血浆N末端B型脑钠肽（NT—proBNP）和肺功能。结果术后两组患者的LVEF均有明显降低，并且对照组降低更明显（t=2．659，P〈0．05），两组LVEDD和NT—proBNP术后均有明显升高，并且对照组升高更明显（t=3．226、2．726，均P〈0．05）。术后两组的肺功能均有明显降低，与观察组比较，对照组降低更明显（t=2．620、2．094、3．016，均P〈0．05）。结论非体外循环下行冠脉搭桥手术不仅创伤小，而且对心、肺影响小。

Objective To study the effect of off-pump coronary artery bypass on heart and lung function of patients. Methods 206 patients were randomly divided into the observation group （ n = 103 cases） and the control group（ n = 103 cases）. The patients in the observation group were operated through off-pump coronary artery bypass, while the patients in the control group were operated through on-pump coronary artery bypass. Left ventricular ejection fraction（ LVEF）, left ventricular end-diastolic diameter（ LYEDD）, plasma N-terminal B-type natriuretic peptide （NT- proBNP） and pulmonary function were measured in two groups. Results The postoperative LVEDD and NT-proBNP of the two groups significantly increased, and the control group increased more significantly （ t = 3. 226,2. 726, all P 〈 0.05 ）. Postoperative lung function were significantly lower in both groups, and compared with the observation group, postoperative lung function in control group decreased more significantly （ t = 2. 620,2. 094,3. 016, all P 〈 0.05 ）. Conclusion Off-pump coronary artery bypass not only was less trauma,but also affect small for the heart,lungs.