不同吻合技术对非体外循环冠状动脉旁路移植术吻合口通畅率的比较分析

Comparative analysis of the patency rates of anastomotic stoma with different anastomosis techniques in off-pump coronary artery bypass grafting

回顾性分析126例非体外循环冠状动脉旁路移植术(OPCAB)患者临床资料,单支桥50例,序贯桥76例,比较OPCAB单支桥与序贯桥吻合口通畅情况,评价序贯吻合技术在OPCAB的应用效果。序贯桥近端血流速度及总吻合口通畅率均高于单支桥(P<0.05);序贯桥中间吻合口通畅率高于序贯桥远端吻合口及单支桥远端吻合口(P<0.05);单支桥与序贯桥吻合口通畅率在不同冠脉系统间差异均无统计学意义。OPCAB应用大隐静脉行序贯桥较单支桥有更好的通畅率,序贯吻合尽量将条件好的靶血管安排在桥最远端。

To retrospectively analyze the clinlical data of 126 patients who were underwented off-pump coronary artery bypass grafting （OPCAB） ,50 cases were executed with individual bridges,76 cases were executed with se- quential bridges, the patency rates of anastomoses on individual and sequential bridges after OPCAB were compaled and the effect of the sequential anastomotic techniques on OPCAB were evaluated. The proximal blood flow velocity and the total patency rates of anastomoses onsequential bridges wele both higher than that on individual bridges （ P 〈 0.05 ）. The patency rates of side - to - side anastomoses on sequential bridges wele better than end - to - side ones on sequential bridges and end - to - side ones on individual bridges （ P 〈 0.05）. There was no diffelence in the patency rates of individual bridges among three coronary arterial systems, neither of sequential bridges. The pa-tency of sequential bridges with saphenous vein graft were better than of individual bridges after OPCAB. When pefforminng sequential anastomosis it would be better to place the target vessels with better conditions at the distal end of the bridges.