颈动脉狭窄患者冠状动脉旁路移植术后早期脑血管意外的对比分析

The relationship of carotid artery stenosis and early postoperative cerebrovascular accident in patients undergoing coronary artery bypass grafting

目的对比分析颈动脉狭窄患者行体外与非体外循环冠状动脉旁路移植术后早期脑血管意外的差异。方法选择100例颈动脉狭窄行冠状动脉旁路移植术患者，按随机数字表法分为体外循环组44例，非体外循环组56例，对比分析两组术后早期（术后48h内）脑血管意外发生率。结果体外循环组8例（18．2％）患者发生了术后早期脑血管意外，其中1例（2．3％）发生脑梗死；7例（15．9％）发生短暂性脑缺血发作；没有脑出血病例。非体外循环组术后早期脑血管意外发生率低于体外循环组[5．4％（3／56）比18．2％（8／44]，差异有统计学意义（χ^2=4．141，P=0．042）。结论非体外循环冠状动脉旁路移植术可以减少颈动脉狭窄患者术后早期脑血管意外的发生。

Objective To investigate the relationship of carotid artery stenosis and early postoperative cerebrovascular accident in patients undergoing off-pump coronary artery bypass grafting. Methods One hundred patients with carotid artery stenosis were divided into two groups by random digits table method： off and on-pump coronary artery bypass grafting group. The incidence of early cerebral vascular accident after operation in two groups （48 h after operation） was compared and analyzed. Results The rate of early postoperative cerebral vascular accident in on-pump coronary artery bypass grafting group was 18.2% （8/44）, 1 patient occurred cerebral infarction, 7 patients occurred transient ischemic attack, none occurred cerebral hemorrhage. The rate of early postoperative cerebral vascular accident in off-pump coronary artery bypass grafting group was 5.4%（3/56）. The rate of early postoperative cerebral vascular accident between two groups had significant difference （ χ^2 = 4.141,P = 0.042）. Conclusion The patients with carotid artery stenosis with off-pump coronary artery bypass grafting can reduce early postoperative cerebral vascular accident.