非体外循环下序贯旁路移植技术同期行内膜剥脱治疗严重弥漫性冠状动脉病变的临床研究

Clinical Study on the off-Pump Sequential Bypass Graft and Endarterectomy in the Treatment of Severe Diffuse Coronary Artery Disease

目的探讨非体外循环下序贯旁路移植技术同期行内膜剥脱治疗严重弥漫性冠状动脉病变的效果。方法选取2014年1月至2017年1月我院收治的120例严重弥漫性冠状动脉病变患者,按平行对照法分为研究组(n=60,非体外循环下序贯旁路移植技术同期行内膜剥脱治疗)与对照组(n=60,非体外循环下冠状动脉旁路移植技术同期行内膜剥脱治疗)。术后随访1年,对比两组的临床治疗效果。结果研究组的围手术期并发症发生率为6.67%,低于对照组的20.00%(P <0.05)。两组的围手术期死亡率比较差异无统计学意义(P>0.05)。术后1年,研究组的吻合口、桥血管通畅程度均优于对照组(P <0.05)。结论采用非体外循环下序贯旁路移植技术同期行内膜剥脱治疗严重弥漫性冠状动脉病变的效果更佳,能够减少围手术期并发症的发生,改善吻合口、桥血管通畅程度,值得临床推广。

Objective To explore the effect of off-pump sequential bypass graft and endarterectomy in the treatment of severe diffuse coronary artery disease.Methods 120 cases of patients with severe diffuse coronary artery disease admitted to our hospital from January2014 to January 2017 were selected and divided into study group(n = 60,off-pump sequential bypass graft and endarterectomy)and control group(n = 60,off-pump coronary artery bypass graft and endarterectomy)according to the parallel comparison method.After 1 year of follow-up,the clinical treatment effect was compared between the two groups.Results The incidence of perioperative complications of the study group was 6.67%,lower than 20.00% of the control group(P<0.05).No statistical difference was found in the perioperative mortality between the two groups(P>0.05).1 year after surgery,the patency degree of anastomotic site and bridge vessel of the study group was better than that of the control group(P<0.05).Conclusions Off-pump sequential bypass graft and endarterectomy in the treatment of severe diffuse coronary artery disease has better effect,can reduce the perioperative complications,and improve the patency degree of anastomotic site and bridge vessel,which is worthy of clinical promotion.