非体外循环下冠状动脉搭桥的临床探讨

Clinical study of coronary artery bypass grafting without cardiopulmonary bypass

目的 总结非体外循环下冠状动脉搭桥的临床经验。方法 在非体外循环下行冠状动脉搭桥术 1 0例 ,2例左前外侧小切口 ,1例胸骨下段正中小切口 ,7例胸骨正中切口。搭桥支数 1～ 4支 ,平均 ( 2 3± 1 3)支 ,均应用左侧乳内动脉搭于左前降支。结果 1 0例患者术后均恢复良好 ,痊愈出院 ;平均住院费用下降。 2例出现并发症 ,经治疗痊愈。结论 非体外循环冠状动脉搭桥术创伤小、安全 ,但对手术操作技术要求高 ,需要特殊设备 ,且应具有一定的手术适应症。

Objective To summarize our experience of coronary artery bypass grafting(CABG)without cardiopulmonary bypass. Methods Ten patients,9 men and 1 woman,underwent CABG without cardiopulmonary bypass.Seven patients were through medial sternotomy incision, 2 were through left anterior small thoracotomy and 1 through lower hemisternotomy.The mean graft was 2.3±1.3(range 1 to 4). Left internal mammary artery was used as coronary artery bypass conduits on 10 patients. Results Ten patients were discharged uneventfully. The expense in hospital was decreased. Two patients complicated low cardiac output and they recovered by treatment. Conclusion CABG without cardiopulmonary bypass is less invasively and safely.But this operation needs certain surgical technique and special appliance.The master of surgical indication is very important for success of operation.