老年患者同期行冠脉搭桥术合并肺部手术的中远期疗效分析

Analysis of the mid and long term effect of coronary artery bypass grafting combined with lung resection

目的分析冠脉搭桥术同期行肺部手术患者的中远期疗效。方法收集天津市胸科医院心外科2015年1月至2019年1月所有行冠脉搭桥术和肺部手术的超过60岁的老年患者临床资料,共计56例。全部病例先完成冠脉血运重建,再行肺部手术。后坚持随访,明确此类手术中远期效果。结果所有患者术程顺利,平均搭桥(2.5±0.9)支。53例行同期胸骨正中切口手术,2例行同期不同切口手术,1例行左前外侧切口手术。1例患者住院期间死亡。随访时间13~62月,平均随访时间(28.5±14.0)月,随访过程中失访3例,死亡6例。全组患者1年、3年、5年生存率分别为98.2%、93.6%、76.7%。肺癌患者1年、3年、5年生存率分别为97.0%、88.9%、68.4%。结论同期行冠脉搭桥术合并肺部手术的老年患者中远期结果满意,左前外切口入路提供了新的治疗选择。

Objective To analyze the medium and long term effect of underwent simultaneous coronary artery bypass grafting and lung resections.Methods From January 2015 to January 2019,we collected 56 patients which under wentsimultaneous coronary artery bypass grafting and lung surgery from Tianjin chest hospital.All patients completed the reconstruction of coronary blood flow before lung surgery.Follow-up was carried out to determine the long-term effect of this kind of operation.Results All patients had a smooth operation,with an average of(2.5±0.9)grafts.53 patients underwent simultaneous median sternal incision,2 patients underwent simultaneous different incisions,and 1 patient underwent left anterior lateral incision.Chemotherapy was continued in 12 patients with malignant tumor and antituberculosis therapy in 2 patients with pulmonary tuberculosis.One patient died in hospital,three patients were lost during the follow-up,nd six patients died during the follow-up.The follow-up time was 13~62 months,the average follow-up time was(30.9±14.6)months.The 1-year,3-year and 5-year survival rates of all patients were 98.2%,93.6%and 76.7%,respectively.The 1-year,3-year and 5-year survival rates of lung cancer patients were 97.0%,88.9%and 68.4%.Conclusion At the same time,the medium and long-term results of simultaneous CABG and lung resections are satisfactory.The operation through left anterior external approach provides a new treatment option for these patients.