冠状动脉搭桥手术61例临床分析

Coronary artery bypass grafting in 61 cases

目的 总结 61例冠状动脉搭桥术的临床经验。方法 对自 1997年 11月 - 2 0 0 3年 1月进行冠状动脉搭桥术的 61例病人进行临床分析。本组男 47例 ,女 14例。平均年龄 ( 5 8.62± 8.2 4)岁 ,其中陈旧性心肌梗死2 4例 ,不稳定性心绞痛 3 7例。合并高血压 2 4例、糖尿病 19例、脑梗塞病史 4例、左室室壁瘤 7例、二尖瓣关闭不全 2例、主动脉窦瘤破裂 1例。术前左室射血分数小于 5 0 % 5例。全组 5 9例行常规体外循环下CABG ,2例行OPCAB。结果 本组共行动脉桥吻合 62支 ,静脉桥吻合 13 1支。围术期并发症 :低心排 3例 ,肾功能衰竭 2例。死亡 2例 ,围术期死亡率 3 .3 %。结论 确切、准确的适应症选择。

Objectives To review the clinical experience in 61 patients undergone coronary artery bypass grafting(CABG).Methods From Nov. 1997 to Jan. 2003 61 patients underwent CABG were reviewed , Among them 47 males and 14 females with a mean age of (58.62±8.24) years. There were 24 cases with the history of Myocardial infarction,37 cases with unstable angina, 24 cases with hypertension , 19 cases with diabetes, 4 cases with history cerebral infarction ,7 cases with left ventricular aneurysm, 2 cases with mitral valve regurgitation , and 1 cases with ruptured aneurysm of aottic sinus. Left ventricle ejection fraction less than 50% in 5 cases. Among them 39 cases proformed with conventional CABG, and 2 cases with off-pump coronary artery bypass grafting(OPCAB).Results The numbers of arterial grafts and venous grafts were 62 and 131. Postoperative complications were low output syndrome 3 cases and renal insufficiency 2 cases. There were 2 postoperative deaths with pospital mortalith of 3.3%.Conclusions Proper selection, early detection and correct management of postoperative complications are important to ensure the operation success.