非体外循环冠状动脉搭桥术130例分析

Analysis of 130 consecutive cases of off pump coronary artery by pass

目的 :总结分析连续 130例非体外循环冠状动脉搭桥术 (offpumpcoronaryarterybypass,OPCAB)的早期临床结果 ,介绍OPCAB手术成功的经验和体会 ,以促进OPCAB术式在临床的推广使用。方法 :连续完成OPCAB手术130例 ,没有术中中转体外循环的情况。平均远端吻合口数目 (3.1± 0 .7)个 ,搭桥材料取乳内动脉 94例 ,桡动脉 5 4例 ,大隐静脉 12 0例。结果 :心绞痛症状缓解 ,住院期间无死亡 ,机械通气时间 (9± 5 )h ,输血 38例 ,监护时间 (5 8±2 5 )h。术后并发症 :纵隔炎 1例 ,围手术期心肌梗死 1例 ,新发脑卒中 1例 ,肾功能恶化 2例 ,室颤 1例 ,二次开胸止血 1例。主动脉内球囊反搏 14例。结论 :OPCAB手术安全可行 ,近期疗效满意 。

Objective: To analyze early clinical r esults of 130 consecutive patients undergoing off pump coronary artery bypas s (OPCAB) procedure, and introduce ou r experiences to perform OPCAB successfully. Methods: OPCAB wa s performed in 130 consecutive patients without conversion to cardiopulmonary bypass. The average n umber of distal anastomoses was (3.1±0.7) and the grafts used were 94 le ft internal mammary arteries (LIMA), 54 radial arteries (RA) and 120 saphenous vei ns. Results: No in-hospital death happened. The extubati on time was (9±5)h and the ICU stay was (58±25)h. There was a significant reduction in blood tra nsfusi on (29%). The operative complication was 5.4%, including myocardial infarction, bl eeding, stroke and mediastinitis (0.07%, respectively), new renal failure and l ife-threatening arrhythmia(0.15%, respectively). Conclusion: Our experience sugges ts that OPCAB procedures are feasible and safe for most patients , and suitable for a wider application in clinical practice.