非体外循环与常规冠状动脉旁路移植术治疗重症冠心病的对比分析

目的：探讨重症冠心病患者非体外循环下冠状动脉旁路移植术（OPCAB）的可行性和优越性。方法：回顾性分析425例重症冠心病的冠状动脉旁路移植术临床资料。其中非体外循环下冠状动脉旁路移植术（OPCAB组）268例，占63．1％；常规体外循环下冠状动脉旁路移植术（CCABG组）157例。比较两组术后早期死亡率及合并症的发生情况。结果：OPCAB组搭桥（4．09±0．75）支／人，CCABG组搭桥（4．17±0．86）支／人（P〉0．05）。两组新发心房纤颤、围术期心肌梗塞、肾功能不全、肺部并发症发生率差异无显著性（P〉0．05）。与CCABG组比较，OPCAB组手术死亡率、呼吸机使用时间、ICU停留时间、术后输血量、二次开胸率、神经系统并发症发生率明显降低或减少（P〈0．05～〈0．01）。结论：非体外循环下冠状动脉旁路移植术在重症冠心病患者中安全可行，临床效果好。

Compare analysis of off-pump and conventional coronary artery bypass grafting for the treatment of severe coronary artery disease

Objective： To analyze the feasibility and the superiority of the off-pump coronary artery bypass grafting （OPCAB） in patients with severe coronary artery disease. Methods： A retrospective study was carried out in 425 cases with severe coronary artery disease underwent CABG, in which 268 cases （63. 1 %） underwent OPCAB and 157 cases underwent CCABG. The early post--operative mortality and complications of two groups were compared. Results： The number of bypass grafts was （4. 09±0. 75） in group OPCAB and （4.17±0.86） in group CCABG, showing no significant difference between two groups （P〉0. 05）. The early post-operative mortality of group OPCAB was significantly lower than that of group CCABG （P〈0. 05）. The time of intubation, ICU--stay, volume of transfusion, reopen and complication of central nervous system （CNS） of group OPCAB were significantly less than those of group CCABG （P〈0.05-〈0.01）. Conclusion： It is safe and feasible to perform OPCAB in patients with severe coronary artery disease.