摘要
目的：介绍并探讨经胸骨下段正中较小切口非体外循环下冠状动脉旁路移植术的外科技术和临床经验。 方法：经胸骨下段正中较小切口游离左侧乳内动脉，用于冠状动脉前降支旁路移植术。对冠状动脉多支病变患者同时游离大隐静脉，用于冠状动脉其它分支旁路移植术。在非体外循环，心脏跳动下，完成冠状动脉单支或多支病变血管的旁路移植术。观察术后恢复情况。 结果：全组２２例患者采用该手术方法，其中５例为前降支单支病变，１７例为多支病变。２２例患者前降支旁路移植术均采用左乳内动脉。平均冠状动脉旁路移植支数：２．４０±１．０４（１～４）支／人。冠状动脉旁路移植的靶血管包括前降支、对角支、右冠状动脉或后降支和高位边缘支。全组患者术后恢复顺利，无严重术后并发症和死亡。患者术后平均８．１±１．６天痊愈出院。 结论：该手术方法创伤较小，安全易行，对有手术适应证的多支病变患者是一种较好的微创冠状动脉旁路移植手术方法。
Objective:To introduce a s urgical tech nique and results of off-pump coronary a rtery bypass grafting(OPCABG)th rough limited lower sternotomy. Methods:From May 2000 to Decembe r 2000,22 patients,aged 45-69 years,underwe nt OPCABG through limited lower sternoto my(skin incision range from 9 cm to 12 cm).Among them there were 5 with single left anterior d escending coronary artery(LAD)l esion and 17 with multiple coronary artery lesions .The target vessels includ those of LAD,d iagonal,right coronary artery,posterier d escending coronary artery or obtuse marg inal branches. Results:In all the patients,left intern al mammary arteries were used as LAD byp ass grafts and had successful off-pump C ABG.After operation,all the patients reco vered uneventfully without any severe po stoperative complications or deaths.Hosp ital stay was from 6 to 11 days(mean 8 days). Conclusions:OPCABG through limited low er sternotomy is safe and easy to manipu late.It can be used not only for a singl e LAD grafting,but also for multiple ves sel grafting.
出处
《中国循环杂志》
CSCD
北大核心
2001年第4期296-298,共3页
Chinese Circulation Journal
基金
国家劳动人事部回国启动基金资助项目(课题号50-99102)
