摘要
目的对比研究在非体外循环冠状动脉搭桥术中应用冠状动脉分流器的临床效果。方法 86例不停跳冠状动脉搭桥患者分为两组：应用冠状动脉分流器组（实验组,43例）和不应用冠状动脉分流器组（对照组,43例）,术后1~3天监测肌酸激酶同工酶（CK-MB）、心肌肌钙蛋白I（c Tn I）、N末端脑利钠肽前体（NT-pro BNP）等指标,并记录并发症发生率、呼吸机使用时间、监护室入住时间及术后住院时间。结果两组病例均痊愈出院。两组人均冠状动脉搭桥支数3~5支,实验组3.6±0.7支,对照组3.6±0.6支,两组没有显著性差异。实验组术后CKMB、cTn I、NT-pro BNP及并发症发生率低于对照组（P〈0.05）,实验组呼吸机使用时间、监护室入住时间及术后住院时间显著缩短（P〈0.05）。术后1个月、3个月、6个月两组患者左心室射血分数（LVEF）、左心室舒张期末内径（LVEDD）均显著改善,无心绞痛复发。结论在不停跳冠状动脉搭桥术中,应用冠状动脉分流器可以显著减少心肌缺血损伤,对降低围手术期急性心肌梗死发生率、并发症发生率,保护心脏功能,缩短术后恢复时间均有显著临床效果。
Aim To study the clinical effect of coronary artery shunt in off-pump coronary artery bypass.Methods 86 cases of off-pump coronary artery bypass grafting were divided into two groups： application of coronary artery shunt group（ experimental group,43 cases） and no application of coronary artery shunt group（ control group,43 cases）,creatine kinase-MB isoenzyme（ CK-MB）,cardiac troponin I（ c Tn I）,and N-terminal pro-brain natriuretic peptide（ NTpro BNP） were monitored for 1 ~ 3 days after operation,and complication rate,ventilation time,ICU stay time and hospitalization time after operation were recorded. Results All cases were cured. The per capita number of coronary artery bypass grafting was 3 ~ 5 in the two groups,the number of coronary artery bypass grafts in the experimental group was 3. 6± 0. 7,the number of coronary artery bypass grafts in the control group was 3. 6 ± 0. 6,there was no significant difference in the two groups. CK-MB,c Tn I,NT-pro BNP and complication rate were lower in the experimental group than those in the control group（ P〈0. 05）. The ventilation time,ICU stay time and hospitalization time after operation were significantly shortened in the experimental group（ P〈0. 05）. The left ventricular ejection fraction（ LVEF）,left ventricular end-diastolic diameter（ LVEDD） were significantly improved after 1 month,3 months,and 6 months after operation.Conclusion Coronary artery shunt can significantly reduce myocardial ischemic injury in off-pump coronary artery bypass grafting,and has significant clinical effect on reducing the incidence of perioperative acute myocardial infarction and complicationrate. It also has significant clinical effect on the protecting cardiac function and shortening the postoperative recovery time.
作者
王圣
程兆云
赵子牛
权晓强
魏宇
夏东升
李建强
胡俊龙
轩继中
WANG Sheng CHENG Zhao-Yun ZHAO Zi-Niu QUAN Xiao-Qiang WEI Yu XIA Dong-Sheng LI Jian-Qiang HU Jun-Long XUAN Ji-Zhong(Department of Cardiovascular Surgery, Henan Provincial People＇ s Hospital, Zhengzhou, Henan 450003, Chin)
出处
《中国动脉硬化杂志》
CAS
北大核心
2016年第10期1035-1038,共4页
Chinese Journal of Arteriosclerosis
