摘要
目的 探讨内镜下采集大隐静脉应用于冠状动脉旁路移植术（coronary artery bypass grafting, CABG）中的早期临床效果. 方法 2004年4月～2005年5月,对89例采用内镜下取大隐静脉行CABG（内镜组）,在膝关节中部做2 cm切口,应用VasoView 5内镜血管采集系统游离获取大隐静脉,并与2003年4月～2005年3月38例采用传统切开法取大隐静脉行CABG（常规组）进行比较,比较2组术后下肢切口并发症、恢复行走时间、患肢疼痛麻木感及肿胀、术后6个月通畅率.结果 内镜组取大隐静脉2～3支,平均2.6支;内镜组下肢并发症（6例）与常规组（8例）相比明显减少（χ^2=4.197,P＝0.040）;内镜组患肢疼痛、麻木感7例及肿胀9例与常规组（分别为36、30例）相比明显减少（χ^2=89.740,P＝0.000;χ^2=59.299;P＝0.000）;内镜组恢复行走时间（2.3±0.9） d比常规组（3.4±1.6） d明显缩短（t=-4.952,P=0.000）;内镜组术后6个月通畅率96.0%（48/50）与常规组95.3%（19/20）相比无明显差别（χ2=0.000,P=1.000）. 结论 CABG中应用内镜下采集大隐静脉能够减少创伤,明显降低术后下肢并发症,减轻术后下肢切口疼痛.
Objective To observe the clinical effects of endoscopic great saphenous vein harvesting （ESVH） in coronary artery bypass grafting. Methods Endoscopic great saphenous vein harvesting was performed in 89 patients undergoing coronary artery bypass grafting （CABG） from April 2004 to May 2005. An incision 2 cm in length was made on the knee joint and the great saphenous vein was harvested using the VasoView-5 system. Clinical data of the 89 patients （Endoscopic Group） were compared with another 38 patients undergoing conventional great saphenous vein harvesting for CABG from April 2003 to March 2005 （ Conventional Group） in respect of complications of the leg, the recovery time to walking, and the patency rate at 6 postoperative months. Results The number of harvested vein grafts in the Endoscopic Group was 2 - 3 （ mean, 2.6）. Complications of the leg were significantly less in the Endoscopic Group （6/89） than in the Conventional Group （8/38） （x^2 = 4. 197, P = 0. 040）. The occurrence of pain and numbness of the leg was 7/89 in the Endoscopic Group and 36/38 in the Conventional Group （x^2 = 89. 740, P = 0. 000）. The occurrence of swelling of the leg was 9/89 in the Endoscopic Group and 30/38 in the Conventional Group （x^2 = 59. 299, P = 0. 000）. The recovery time to walking was significantly shorter in the Endoscopic Group （2.3 ±0.9 d） than in the Conventional Group （3.4 ±1.6 d） （t = -4. 952, P = 0. 000）. There was no significant difference in the patency rate at 6 postoperative months between the Endoscopic Group （96.0% , 48/50） and the Conventional Group （95.3% , 19/20） （x^2 =0. 000, P = 1. 000）. Conclusions Use of endoscopic vein harvesting in coronary artery bypass grafting decreases the incidence of postoperative leg-wound infections, postoperative pain, and length of hospital stay.
出处
《中国微创外科杂志》
CSCD
2006年第6期423-425,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
内镜
大隐静脉
冠状动脉旁路移植术
Endoscope
Great saphenous vein
Coronary artery bypass grafting
