左胸小切口与胸骨正中切口冠状动脉搭桥术的比较

Evaluate minimally invasive direct CABG surgery compare tradition CABG

目的比较微创左胸小切口与传统胸骨正中切口冠状动脉搭桥术的优缺点。方法从2006年3月至2008年3月,对66例冠心病经左胸微创小切口实施非体外循环左乳内动脉前降支搭桥术,时42例冠心病经传统正中切口实施非体外循环左乳内动脉前降支搭桥术。比较术前基本情况及手术切口长度、切口感染情况与住院时间,术后第1、2、3周及1、2、3、6个月进行随访。结果左胸小切口组与胸骨正中切口组均无手术死亡,无术后出血,无心绞痛症状,仅胸骨正中切口组出现1例切口感染,其余无切口感染裂开。左胸小切口组较胸骨正中切口组手术切口小,住院时间短。随访半年无心脏事件发生。结论左胸微创小切口非体外循环冠状动脉搭桥术安全、可靠,近期临床效果显著。适用于单支血管病变或联合经皮冠状动脉支架术治疗重症冠心病。

Objective To evaluate minimally invasive direct CABG surgery compare tradition CABG.Methods 66 patients were performed minimally invasive direct CABG surgery from March 2006 to 2008.42 patients were underwent tradition CABG with full median sternotomy group at the same period.Comparing two groups in term of the length of incision,incision infection and hospital stay time,All patients were followed up post operation in 1 week,2 week3,3week3,1 month,2 months,3months and 6 months.Results No operation death,no post operation bleeding,no recurrence angina and Nero complication in two groups.;only 1 patient in tradition CABG group had incision infection.Compare two groups,minimally invasive direct CABG surgery has smaller size incision,and shorter hospital stay time.All patients were free from cardiac accident six months follow up.Conclusion Minimally invasive direct CABG surgery is a safe and reliable procedure,which elimination of cardiopulmonary bypass and its associated adverse,suitable for single LAD and severe complex multiple vessel disease had the same procedure combine PCI.