冠状动脉旁路移植术大隐静脉分段切开获取与全程切开获取的近期对比

Comparative study of vein graft patency between segmental incision and open saphenous vein harvesting in coronary artery bypass grafting

目的比较冠状动脉旁路移植术中分段切开与全程切开获取大隐静脉近期临床疗效。方法纳入温州医科大学附属第一医院2013年1月至2015年12月行冠状动脉旁路移植术患者资料,进行回顾性研究。据术中大隐静脉获取方式分为2组,全程切开组99例,分段切开组114例。收集2组患者的术前临床资料,并对术中大隐静脉获取时间、获取长度、获取质量及早期临床结果、下肢切口并发症情况进行比较。术后1年应用冠脉CTA检查,比较静脉桥血管通畅率。结果 2组患者临床基础资料无明显统计学差异(P>0.05),分段切开组下肢切口并发症发生率较全程切开组低,差异有统计学意义(P<0.05)。2组术后1年冠脉CTA检查静脉桥血管通畅率差异无统计学意义(P>0.05)。结论分段切开获取大隐静脉技术安全可行,在降低术后下肢切口并发症方面有优势,对术后近期通畅率无明显影响,是临床大隐静脉取材较为经济和微创的方法。

Objective To compare vein graft quality and pateney between the segmental incision and the open saphenous vein harvesting in coronary artery bypass grafting. Methods The data of patients underwent CABG in the First Affiliated Hospital of Wenzhou Medical University from January 2013 to December 2015 were retrospectively analyzed. The patients were devided into 2 groups, which is 99 open and 114 sagmental incision, by the way of harvesting. The operative risk factors, harvesting time and length of venous grafts, as well as the inci- sion complications were compared between the above two groups. One year after operation, the vein graft pateney was detected by the coronary artery CTA. Results No significant differences in the risk factors of incision compli- cations were observed between the two groups, but the incidence of various incision complications was significantly reduced in the segmental incision group （P 〈 0.05）. No significant difference in patency rate of venous grafts was observed between two groups at 1 years post-operation. Conclusion Segmental incision saphenous vein harvesting was safe and feasible, which can decrease the incision complications without obvious effect on postoperative patency.