冠状动脉旁路移植术治疗冠心病

Coronary artery bypass grafting in the treatment of coronary artery disease

目的 分析冠状动脉搭桥术 (CABG)治疗冠心病的早期效果和经验。方法 18例冠心病患者中 16例为多支冠状动脉病变 ,17例心绞痛 (CCS)Ⅲ～Ⅳ级。 15例为常规体外循环下CABG ,1例为体外循环心脏不停跳下CABG ,2例为非体外循环心脏不停跳下冠状动脉搭桥术 (OPCAB)。 15例采用左乳内动脉 (LIMA)与左前降支 (LAD)搭桥 ,余均为大隐静脉桥。同期行二尖瓣置换 (MVR) 2例 ,主动脉瓣置换(AVR) 1例。人均搭桥 3 4 5支。结果 18例CABG临床效果满意 ,无手术死亡。 1例术后出血 ,低血压时间较长 ,出现脑功能不全。 1例术后呼吸功能不全 ,经气管造口、机械通气改善。患者心绞痛症状完全消失。结论 CABG是治疗冠心病的一种安全和有效的方法 ,OPCAB创伤轻、并发症少。

Objective To retrospectively review the experience and early clinical results of coronary artery bypass grafting (CABG) in the treatment of coronary artery disease. Methods CABG was performed on 18 consecutive patients.16 of them had multiple coronary artery disease.17 patients had class Ⅲ or Ⅳ preoperative angina.16 patients received CABG under cardiopulmonary bypass (CPB) and 2 direct coronary artery bypass without CPB(OPCAB). The average number of grafts was 3.45 and the left internal mammary artery was used in 15 patients and the saphenous vein remaining in all patients.Combined treatment was employed with mitral valve replacememt(MVR) in 2 cases and aortic valve replacement (AVR) in 1. Rusults There was no operative mortality. All patients were angina free at a mean follow-up period of 21.8 months. Conclusion CABG is a safe and effective way for the treatment of cononary artery disease.