冠状动脉旁路移植术的临床应用

目的总结332例冠状动脉旁路移植术的临床经验。方法回顾分析冠状动脉旁路移植术332例患者的资料,男254例,女78例,平均年龄（61.8±9.2）岁。左室射血分数（50.8±7.3）%（69%-28%）;〈50%51例,其中〈40%27例。全组行体外循环下冠状动脉旁路移植术184例,行非体外循环心脏跳动下冠状动脉旁路移植术148例。结果全组共行动脉桥吻合318支,静脉桥798支;围术期并发症低心排15例,肺功能衰竭7例,肾功能衰竭7例。围术期死亡10例,病死率3.0%。结论充分的术前准备,熟练的手术技术,良好的心肌保护及合理的术后处理是提高冠状动脉旁路移植术疗效的关键。

A review study on coronary artery bypass grafting

Objective To review the clinical experience in 332 patients undergone coronary artery bypass grafting（CABG）.Methods Two hundred and thirty three patients underwent CABG from Nov.1997 to Jun.2010 were reviewed.Of 254 males and 78 females with a mean age of（61.8 ±9.2） years.Left ventricle ejection fraction（EF） was 52.8±7.3（69%-28%）,and there were 51 cases with EF50%,27 cases with EF40%.Among them 184 cases performed with conventional CABG,and 148 cases with off-pump coronary artery bypass grafting（OPCAB）.Results The numbers of arterial grafts and venous grafts were 318 and 798 respectively.There were 15 cases with low output syndrome and 7 cases with respiratory failure and 7 cases with renal insufficiency after operation.There were 10 postoperative deaths with a mortality rate 3.0%.Conclusion Scientific surgical strategies,sufficient ready of preoperative,excellent surgical techniques,favourable myocardial preservation and correct management of postoperative complications are important to ensure the operation success.CABG surgery is safe and effective in patients with coronary artery disease.