70岁以上冠脉三支病变患者体外循环与非体外循环冠状动脉旁路移植术的对比

Clinical contrast research of coronary bypass operation under extacorpeal circulation and non-extracorpoeal circulation in patients over 70 years old with coronary triple-vessel disease

目的比较70岁以上合并冠脉三支病变的老年患者体外循环与非体外循环两种冠状动脉旁路移植术的相关数据,为临床提供经验。方法选取我院2014年1月至2017年6月行冠状动脉旁路移植术的70岁以上老年患者115例。其中接受体外循环治疗51例,非体外循环治疗64例,并对两组相关临床资料进行对比研究。结果与体外循环组相比,非体外循环组在手术时间、桥血管移植数目、术后胸腔引流量差异无统计学意义(P>0.05),在围手术期输血量、呼吸机辅助时间、ICU住院时间、术后并发症、总住院费用方面明显减少,差异有统计学意义(P<0.05)。结论随着技术的进步和术者经验的成熟,非体外循环冠状动脉旁路移植术在合并三支病变的老年患者中更安全、有效,可以进一步临床推广。

Objective Through compare the clinical data of two kinds of coronary bypass operation under extacorpeal circulation and non extracorpoeal circulation in patients over 70 years old with triple-vessel disease, and to provide the clinicalexperience. Methods Choose the patients hospitalized from department of thoracic surgery 115 cases who had had coronary arterybypass grafting surgery from January 2014 to June 2017. There were 51 cases accepted extracorporeal circulation surgery, another 64 cases accepted non-extracorpoeal circulation surgery. And make a comparative study of the clinical data of two kinds of coronary bypass operation. Results Compared with the extacorpeal circulation group, the operation time, bypass vessel numb, the thoracic drainage were no statistic difference in non-extracorpoeal circulation （P 〉 0.05）. The amount of transfused blood, mechanical ventilation time, hospitalized time in ICU, postoperative complications, total hospitalization time were significantly lower than extacorpeal circulation group, the difference was statistically significant （P 〈 0.05）. Conclusions As the develop- ment of technology and the maturity of the operator＇ s experience, off-pump coronary artery bypass grafting is safe and effective in elderly patients, which could be further promoted in clinical practice.