70岁以上老年患者冠状动脉旁路移植术临床结果及10年随访分析

Clinical outcome of coronary artery bypass in patients≥70 years old and analysis of 10-year follow-up

目的观察70岁以上冠状动脉旁路移植术(CABG)患者的特点及术后长期生存状况。方法回顾性总结分析94例70岁以上(含70岁)CABG患者术前、术中、术后和10年随访资料,并以192例70岁以下CABG患者作为对照组进行比较分析。结果 1平均远端吻合口数两组无明显差别。2术后气管插管时间、住院时间、肺部感染率和肾功能不全等发生率,≥70岁组显著多于<70岁组。3术后10年随访结果显示≥70岁组左室射血分数(LVEF)值明显低于<70岁组。≥70岁组术后10年LVEF值比术前明显降低。410年内总病死率、因心脏原因病死率和因心脏以外原因病死率,≥70岁组均显著高于<70岁组。结论 1≥70岁的患者术后并发症多,康复较长;2高龄患者术后长期生存质量相对较差,病死率也比较高。

AIM To explore the role of coronary artery bypass grafting in septuagenarians. METHODS Preoperative, operative and postoperative data of 94 patients aged ≥70 years and data of 10-year follow-up were statistically analyzed, which compared with that of 192 cases aged 〈 70 years. RESULTS The mean distal anastomoses was not significant between groups. Intubation time, postoperative stay, morbidity of renal function failure and pulmonary infection were longer in the group ≥70 years of age than in the 〈 70 year-old group. EF value in the group ≥ 70 years of age was higher than in the group 〈 70 years of age. Ten-year mortality follow-up was significantly higher in the group 270 years of age than in the group 〈 70 years of age. CONCLUSION Septuagenarians had higher morbidities of chronic ob- struction pulmonary disease and renal function disease in preoperation, and had more complications and longer postoperative recovery time. Coronary artery bypass grafting （CABG） in patients ≥70 years of age can be performed with low mortality and significant symptomatic benefit. Patients should not be denied CABG because of age alone. Survival quality of life in patients ≥70 years of age was poorer than in the group 〈 70 years of age.