摘要
目的 :探讨冠心病患者行体外循环冠状动脉旁路移植术 (EC CABG)和非体外循环冠状动脉旁路移植术 (NEC CABG)心功能恢复的效果。 方法 :回顾性分析 2 0 0 0年 1月至 2 0 0 1年 12月连续 12 0例冠状动脉旁路移植术 ,其中EC CABG组 6 9例 ,手术在体外循环下进行 ;NEC CABG组 5 1例 ,不用体外循环 ,心脏跳动下完成旁路移植手术。应用肺动脉漂浮导管连续监测心排血量 (CO)、心排血指数 (CI)、左心室每搏功指数 (LVSWI) ,记录围术期主动脉内球囊反搏 (IABP)使用情况、机械通气时间、正性肌力药物用量、血液超滤的使用情况、手术时间、输血量等。 结果 :NEC CABG组CO、CI、LVSWI较EC CABG组恢复快 ;NEC CABG组使用IABP(1.9% )较EC CABG组 (8.6 % )明显降低 (P <0 .0 5 ) ;NEC CABG组机械通气时间较EC CABG组短 ,正性肌力药物使用量明显减少 ,且EC CABG组多需要进行血液超滤。 结论 :非体外循环冠状动脉旁路移植术显示了良好的心功能恢复效果 ,加快了患者的康复。
Objective: To evaluate the heart function recovery in non extracorporeal circulation coronary artery bypass(NEC CABG) and extracorporeal circulation coronary artery bypass grafting(EC CABG). Methods: Totally 120 consecutive patients of coronary artery bypass graft (CABG) surgery from Jan. 2000 to Dec. 2001 were included, and were divided into 2 groups: 69 cases in EC CABG group with cardiopulmonary bypass(CPB); and 51 cases in NEC CABG group with off pump on the beating heart. Swan Ganz conduit was used to detect the changes of cardiac output(CO) and cardiac index(CI) and other hemodynamic parameters. The use of intra aortic balloon counterpulsation (IABP) was calculated and mechanical ventilation time and dosages of vasoactive agents and another incidence were all recorded. Results: NEC CABG group CO and CI were improved compared with EC CABG group, IABP use was 1.9% in NEC CABG group and 8.6% in EC CABG group ( P < 0.05), the NEC CABG group of mechanical ventilation time was shorter compared with EC CABG group; Dosages of vasoactive agents were less than that of EC CABG group and hemofiltration was mainly in group EC CABG. Conclusion: Non extracoporeal circulation coronary artery bypass graft has satisfactory effects of myocardic protection.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2003年第3期258-260,共3页
Academic Journal of Second Military Medical University
基金
上海市卫生系统百名跨世纪优秀学科带头人培养计划基金 (97BR0 4 7)
关键词
体外循环
非体外循环
冠状动脉旁路移植术
心功能恢复
冠状动脉疾病
extracorporeal circulation
non extracorporeal circulation
coronary artery bypass graft
heart function recovery
coronary disease
