冠状动脉旁路移植术218例临床分析

Clinical analysis of coronary artery bypass grafting in 218 cases

目的 总结冠状动脉旁路移植术 (CABG)治疗冠心病的经验。方法 回顾分析 2 0 0 1年 1月～ 2 0 0 2年 2月完成的CABG 2 18例 ,体外循环下冠状动脉旁路移植手术 (CCABG) 15 2例 ,非体外循环下冠状动脉旁路移植手术 (OPCAB) 66例 ,对手术方法、主要并发症和围术期治疗进行分析。结果 院内死亡 5例。 1例术后第 14天死于肺部感染、急性肾功能衰竭 ;1例术后第 3天死于心肌梗死 ;1例术后第 2天死于急性肺梗死 ;2例因ARDS、多器官功能衰竭死亡。余 2 13例治愈出院。随访有 6例复发心绞痛 ,药物治疗有效。结论 严格掌握手术适应证、充分的术前准备、手术技巧的完善、良好的心肌保护及加强围术期处理是提高CABG早期疗效的关键因素。

Objective To summarize the results and experience of coronary artery bypass grafting for coronary artery disease.Methods From Jan. 2001 to Apr. 2002, 218 patients underwent coronary artery bypass grafting. Male 143, female 75. Coronary artery bypass grafting with extracorporeal circulation(ECC) in 152 patients, off-pump coronary artery bypass grafting in 66 patients. Surgical technique, perioperative treatments, death causes and complications were analyzed in all cases.Result 5 patients died in hospital, mortality was 2.3%(5/218), others had favorable outcomes.Conclusions Strict mastery of surgery indictions, advanced oprative methods, excellent myocardial protection and perfect perioperative treatments are pivotal factors of CABG, the efficacy and safety of coronary artery bypass grafting are satisfactory.