摘要
目的 :研究非体外循环冠脉旁路移植 (off- pump CABG)与体外循环冠脉旁路移植 (on- pum p CABG)术后早期左心功能的改变规律。 方法 :于术前、术后即刻 (0 h)、4、8、12、2 0、4 4 h对 2 5例行 CABG的患者 (on- pump12例 ,off- pum p13例 )进行血流动力学检测 ,计算并分析心排血指数 (CI)、左室做功指数 (L VSWI)。 结果 :On- pump组 CI、L VSWI于术后 4 h降至最低点 ,与术前相比有显著性差异 (P<0 .0 1) ,此后回升 ,CI于术后 12 h显著高于术前 (P<0 .0 1) ,但 L VSWI术后 4 4 h仍显著低于术前 (P<0 .0 5 ) ;Off- pump组 CI、L VSWI术后亦下降 ,CI低点出现在术后 4 h,后回升 ,至术后 12 h已显著超过术前(P<0 .0 1) ,但 L VSWI术后呈持续缓慢下降 ,低点在术后 4 4 h;两组间 L VSWI的最大降幅无显著差别。 结论 :在术后早期on- pum p与 off- pump CABG患者的左心功能均会出现下降 ,on- pump CABG组下降早 。
Objective: To assess the left ventricular function of patients received off and on pump coronary artery bypass grafting(CABG) during the early post operative period. Methods: Totally 25 patients underwent CABG(12 on pump, 13 off pump) were selected in our study. Cardiac index (CI) and left ventricular stroke work index (LVSWI) were calculated and analyzed before operation, immediately and 4,8,12 ,20,44 h after operation. Results: LVSWI and CI in patients of on pump group declined to the lowest 4 h after operation( P <0.01). In contrast to LVSWI, which remained depressed until post operative 44 h, CI recovered to pre operative level 8 h after CABG and increased to a significantly higher level 12 h after operation ( P <0.01). CI and LVSWI in off pump CABG patients declined slowly. CI recovered to pre operative level 8 h after CABG and to a significantly high level 12 h after operation. LVSWI remained declining, and its lowest point was 44 h after operation. The magnitude of LVSWI maximal decline was not significant between 2 groups. Conclusion: There exists a transient left ventricular dysfunction in both on and off pump CABG patients early after operation. CABG performed on cardio pulmonary bypass is associated with earlier post operative left ventricular dysfunction, but the differences of the severity are not significant between 2 groups during the early post operative period.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2003年第8期868-870,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 47)
全军医药科研"十五"规划重点课题( 0 1Z0 60 )
