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非体外循环冠脉搭桥术的心肌保护作用 被引量：3

Myocardial Protective Effect of Off-Pump Coronary Artery Bypass Grafting
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摘要 目的 :比较非体外循环冠脉搭桥手术 (OPCAB)和体外循环冠脉搭桥手术 (CABG)围术期心肌损伤程度 ,探讨OPCAB的心肌保护效果。方法 :5 0例病人分为两组 ,A组 2 0例 ,为CABG组 ,B组 30例 ,为OPCAB组。分别于麻醉诱导后、手术结束后即刻、术后 2 4h、72h、16 8h取静脉血标本 ,分别测定心肌肌钙蛋白I水平和CK MB活性 ;另外记录围手术期各项临床指标。结果 :OPCAB组术后辅助呼吸时间较体外组短 (P <0 .0 1) ,而且房颤的发生率较低 (P <0 .0 5 )。CABG组与OPCAB组cTnI、CK MB的术前水平相似 ,而术后即刻、术后 2 4h、72h均较OPCAB组明显升高 (P <0 .0 5或 0 .0 1)。结论 :与CABG相比 ,OPCAB的心肌损伤较轻 ,心肌保护效果较好。 Objective: Our aim was to investigate the protective effect of coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass (CPB) on myocardial injury. Methods: Fifty patients undergone simple CABG were divided into 2 groups:CABG group (n=20),on pump with conventional CPB and cardioplegic arrest,and OPCAB group (n=30),off pump on the beating hearts. Serum level of cardiac troponin I (cTnI) and CK MB activity were determined right after anesthetic and 0,24,72 and 168 hours after operation. Results: The cTnI and CK MB increased significantly in the CABG group 0,24,72 hours after operation. The incidence of atrial fibrillation was higher and mechanical ventilatory support time was longer in CABG group than those in OPCAB greup (P<0.05 ). Conclusion: Off pump coronary artery bypass grafting on beating heart can reduce myocardial injury.
作者 姜春力 谷天祥 章志伟 吴朝晖 高锐
机构地区 中国医科大学附属第一医院心脏外科
出处 《中国医科大学学报》 CAS CSCD 北大核心 2003年第6期534-536,共3页 Journal of China Medical University
关键词 非体外循环 冠状动脉旁路移植术 心肌保护 coronary artery bypass grafting off pump cardiopulmonary bypass myocardial protection
分类号 R654.2 [医药卫生—外科学]
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参考文献10

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同被引文献21

  • 1张冬梅,王妙基,黄念慈,刘红,施伟忠.冠状动脉搭桥围术期心肌损伤标志物的临床意义[J].临床麻醉学杂志,2004,20(12):727-729. 被引量：2
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  • 6Sellke FW, DiMai0 JM, Caplan LR, et al. Comparing on-pump and off-pump coronary artery bypass grafting: numerous studies but few conclusions: a scientific statement from the American Heart Association council on cardiovascular surgery and anesthesia in collaboration with the interdisciplinary working group on quality of care and outcomes research [ J ]. Circulation, 2005,111 ( 21 ) : 2858-2864.
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引证文献3

中国医科大学学报
2003年 第6期

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