摘要
Abstract
Objective To integrative the clinical curative efficacy of the off‐pump coronary artery bypass (OP‐CAB) .Methods 52 patients conforming to the criteria were chosen to perform OPCAB .The physiological indexes changes during operation ,postoperative myocardial enzyme indexes changes and the postoperative heart function changes were studied and discussed .Results All the 52 patients had successful operation .The number of bypass was 1‐6 ,an average of 3 .1 ± 1 .7 ;the operation time was (1 .8-6 .7)h ,an average of (3 .3 ± 1 .5)h .During the operative process ,in the anastomosis of left circumflex ,PaO2 ,HR and MAP had significant changes compared with before an‐esthesia(P<0 .05) .The levels of creatine kinase(CK) ,creatine kinase isoenzyme(CK‐MB) and aspertate aminotrans‐feranse(AST) on postoperative 1 d were significantly higher than those before operation(P<0 .05) ,while the level of lactate dehydrogenase(LDH) had no statistically significant difference (P> 0 .05) .The levels of CK ,CK‐MB and AST at postoperative 1 week were recovered to the normal levels without statistical differences compared with before operation(P> 0 .05) ,while the LDH level was significantly higher than before operation (P< 0 .05) .The ejection fraction in postoperative 3 months was(47 .6 ± 6 .9)% ,which was significantly higher than(39 .1 ± 5 .1)% before op‐eration(P<0 .05) .The ICU treatment time ,assisted respiration time ,ECG monitoring time ,antibiotics using time , eating time ,sitting up time and indwelling drainage tube time in the OPCAB group were significantly less than those in the conventional coronary artery bypass grafting (cCABG) group(P<0 .05) .The total occurrence rate of complica‐tions in the OPCAB group was significantly lower than that in the cCABG group (P<0 .05) .Conclusion Adopting the OPCAB therapy can better reduce the occurrence of myocardial ischemia ,immune injury and reperfusion injury , effectively protect the patients′heart and promote the recovery .So OPCAB is worthy of further clinical promotion and use .关键词
冠状动脉搭桥术/非体外循环/心肌酶/心脏功能Key words
coronary artery bypass/off-pump/myocardial enzyme/heart function
