中国全科医学2017，Vol.20Issue(25)：3117-3121,5.DOI:10.3969/j.issn.1007-9572.2017.25.011
体外循环与非体外循环下冠状动脉旁路移植术的围术期效果及远期预后比较研究
Perioperative Effect and Long-term Outcome of On-pump vs Off-pump Coronary Artery Bypass
摘要
Abstract
Objective To compare the perioperative effect and long-term outcome of on-pump coronary artery bypass (ONCAB) with those of off-pump coronary artery bypass (OPCAB).Methods We obtained and compared the baseline data,perioperative data and follow-up data of 97 cases undergoing ONCAB (ONCAB group),and 150 cases undergoing OPCAB (OPCAB group) in No.2 Cardiovascular Department,Daxuecheng Branch Hospital,Guangdong Provincial Hospital of TCM from November 1998 to December 2009.Results Compared with the patients in the ONCAB group,those in the OPCAB group were older,and they had lower incidence of left main coronary artery lesions (P ＜ 0.05).Patients in the OPCAB group had less number of distal anastomosis,shorter duration of operation,shorter duration of mechanical ventilation,shorter length of stay in the ICU and shorter length of stay,and they used less dopamine,transfused less red blood cells and plasma postoperatively,as well as had less amount of postoperative drainage compared with those in the ONCAB group (P ＜ 0.05).Two groups had no significant difference in the hospital mortality (P ＞ 0.05).Of the 242 cases who survived during the perioperative period,71.1％ (172) were followed up for over seven years,with a mean follow-up period of (11.6 ±2.5) years.Chest tightness/angina pectoris,ST-T wave changes/arrhythmia,graft occlusion were more likely to occur in patients with follow-up period of over seven years in OPCAB group than those in the ONCAB group (P ＜ 0.05),but the mortality rates related to cardiac events and non-cardiac events,and overall mortality were similar in both groups (P ＞ 0.05).Conclusion Patients in the OPCAB group have much better surgical effect,but they have lower long-term patency rate due to more complicated techniques required by OPCAB,and higher recurrence of chest tightness/angina pectoris and incidence of myocardial ischemic changes.关键词
冠状动脉旁路移植术,体外循环/冠状动脉旁路移植术,非体外循环/围手术期/预后Key words
Coronary artery bypass, on-pump/Coronary artery bypass, off-pump/Perioperativeperiod/Prognosis分类
医药卫生引用本文复制引用
胡佳心,阮新民,林宇..体外循环与非体外循环下冠状动脉旁路移植术的围术期效果及远期预后比较研究[J].中国全科医学,2017,20(25):3117-3121,5.基金项目
广东省科技计划项目(2014A020212271) （2014A020212271）
