摘要
目的探讨左胸小切口非体外循环搭桥术治疗冠心病的效果。方法选取郑州市第七人民医院2017年3月至2018年6月收治的82例冠心病患者的临床资料进行分析,根据入路选择方案不同将其分为左胸切口组(41例)与正中切口组(41例),左胸切口组采用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治疗,正中切口组采用非体外循环左乳内动脉前降支搭桥术,对比两组的手术时间、ICU病房时间、呼吸机辅助通气时间以及住院天数,并分别于术后1个月、术后1年对比两组的心功能分级、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF),观察两组的并发症发生情况。结果左胸切口组的手术时间、ICU病房时间、呼吸机辅助通气时间及住院天数均明显低于正中切口组(P<0.05);术后1个月、术后1年,左胸切口组的美国纽约心脏病协会(NYHA)分级、LVEDD、LVEF均明显优于正中切口组(P<0.05)。左胸切口组的并发症发生率为7.32%,正中切口组的并发症发生率为24.39%,左胸切口组明显低于正中切口组,具有统计学意义(P<0.05)。结论与正中切口入路比较,左胸小切口非体外循环搭桥术的各项手术指标更理想,对患者的治疗效果更好,而且术后并发症的发生率更低,值得推广应用。
【Objective】To investigate the effect of left chest small incision non-cardiopulmonary bypass in coronary heart disease.【Methods】The clinical data of 82 patients with coronary heart disease admitted to our hospital from March 2017 to June 2018 were analyzed.According to the different access options,they were divided into left thoracotomy group(41 cases)and median incision group(41 cases).The left thoracotomy group was treated with non-extracorporeal circulation left internal mammary artery anterior descending branch bypass through the left chest minimally invasive small incision,and the median incision group was treated with non-extracorporeal circulation left breast.The operation time,ICU ward time,ventilator assisted ventilation time and hospitalization days of the two groups were compared.The cardiac function grade,LVEDD and LVEF of the two groups were compared one month and one year after the operation respectively,and the complications of the two groups were observed.【Results】The operation time,ICU ward time,ventilator assisted ventilation time and hospitalization days of left chest incision group were significantly lower than those of median incision group(P<0.05);the NYHA grade,LVEDD and LVEF of left chest incision group were significantly better than those of median incision group one month and one year after operation(P<0.05).The incidence of complications was 7.32%in the left thoracotomy group and 24.39%in the median incision group,and the incidence of complications in the left thoracotomy group was significantly lower than that in the median incision group(P<0.05).【Conclusion】Compared with the median incision approach,the operation indexes of left chest small incision bypass surgery are better,the treatment effect is better,and the incidence of postoperative complications is lower,so it is worth popularizing.
作者
陈刚
CHEN Gang(The First Ward of Cardiovascular Surgery,Zhengzhou Seventh People's Hospital(Zhengzhou Cardiovascular Hospital),Zhengzhou,Henan 450000,China)
出处
《中国医学工程》
2020年第12期50-52,共3页
China Medical Engineering
关键词
冠心病
左胸小切口
非体外循环
搭桥术
coronary heart disease
left thoracotomy
non cardiopulmonary bypass
bypass
