非体外循环与体外循环下冠状动脉搭桥术治疗冠心病的效果比较

Effect comparison of off-pump extracorporeal circulation and extracorporeal circulation coronary artery bypass grafting in the treatment of coronary heart disease

目的比较非体外循环与体外循环下冠状动脉搭桥术(CABG)治疗冠心病的临床效果。方法选取2018年5月至2021年4月周口市中心医院收治的62例冠心病患者为研究对象,按照随机数字表法分为对照组与观察组,每组31例。对照组采用体外循环下CABG治疗,观察组采用非体外循环下CABG治疗。比较两组围术期指标、术前、术后3 d心肌损伤情况[肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)]、肝功能[总胆红素(TBIL)、谷氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(GOT)]水平及并发症发生率。结果观察组手术时间、住院时间短,术中出血量少于对照组,差异有统计学意义(P<0.05);术后3 d,观察组CK-MB、cTnI、TBIL、ALT、GOT低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率[6.45%(2/31)]低于对照组[25.81%(8/31)],差异有统计学意义(P<0.05)。结论与体外循环下CABG比较,非体外循环下CABG治疗冠心病的效果更好,能减少术中出血量,缩短手术时间和住院时间,减轻心肌损伤和肝功能损伤,且术后并发症少,治疗安全性高。

Objective To compare the clinical effects of off-pump extracorporeal circulation and extracorporeal circulationcoronary artery bypass grafting(CABG)on coronaryyheartdisease.Methods Sixty-two patients with coronary heart disease in the Central Hospital of Zhoukou from May 2018 to April 2021 were selected and divided into control group and observation group according to random number table method,with 31 cases in each group.The control group was treated with extracorporeal circulation CABG,and the observation group was treated with off-extracorporeal circulation CABG.The perioperative indexes,preoperative and postoperative myocardial injury[creatine kinase isoenzyme(CK-MB),troponin I(cTnI)]and liver function[total bilirubin(TBIL),glutamate aminotransferase(ALT),aspartate aminotransferase(GOT)] levels and the incidence of complications were compared between the two groups.Results Compared with the control group,the operation time and hospital stay in the observation group were shorter and the amount of blood loss was less(P<0.05).At 3 days after surgery,the levels of CK-MB and cTnl,TBIL,ALT and COT in the observation group were lower than those in the control group(P<0.05).The complication rate of the observation group was 6.45%(2/31),which was lower than that of the control group(25.81%,8/31,P<0.05).Conclusions Compared with CABG under extracorporeal circulation,CABG under off-extracorporeal circulation is more effective on coronary heart disease,which can reduce intraoperative blood loss,shorten operation time and hospital stay,alleviate myocardial injury and liver function injury,and has fewer postoperative complications and high therapeutic safety.