【摘要】 背景:研究表明,非体外循环下冠状动脉旁路移植术和体外循环下冠状动脉旁路移植术后患者生活质量无明显差别。导致冠状动脉旁路移植术后患者生活质量下降的主要原因是桥血管病变和心律失常。目的:评价非体外循环下冠状动脉旁路移植术与常规体外循环下冠状动脉旁路移植术相比是否具有优越性。方法:检索2000/2009国内关于检索非体外循环下冠状动脉旁路移植术与体外循环下冠状动脉旁路移植术手术后疗效的临床对比研究,收集相关数据并用RevMan4.2统计软件进行Meta分析。结果与结论:检索并纳入本次研究的文献共16篇,其中行非体外循环下冠状动脉旁路移植术组的病例1392例,行体外循环下冠状动脉旁路移植术组的病例1252例。Meta分析结果示:非体外循环下冠状动脉旁路移植组的手术效果优于体外循环下冠状动脉旁路移植组,非体外循环下冠状动脉旁路移植组在ICU时间、呼吸机辅助时间、住院时间、术后24h引流量、术后并发症上都明显低于体外循环下冠状动脉旁路移植组(P<0.05),但在移植血管数上低于体外循环下冠状动脉旁路移植组(P<0.05),而两组在年龄上差异无显著性意义(P>0.05)。提示近期观察非体外循环下冠状动脉旁路移植术治疗冠状动脉病变比体外循环下冠状动脉旁路移植治疗效果更好,但远期效果如何,尚未形成定论。更多还原

【Abstract】 BACKGROUND: Studies demonstrated that the living quality of patients had no significant differences following off-pump (OPCAB) or on-pump coronary artery bypass grafting (CCAB). The decrease of living quality related to graft lesions and arrhythmia. OBJECTIVE: To evaluate whether OPCAB is superior to conventional CCAB. METHODS: The comparative studies regarding therapeutic effects of OPCAB and CCAB from 2000 to 2009 were searched, and collecting relevant data was Meta analyzed using RevMan 4.2 statistical software. RESULTS AND CONCLUSION: A total 16 documents were included in this study, including 1 392 cases in the OPCAB group and 1 252 cases in the CCAB group. Results of Meta analysis demonstrated that, OPCAB was superior to CCAB in ICU duration, ventilation time, hospitalization time, postoperative 24-hour drainage volume, and postoperative complications (P < 0.05), but the graft number was lower than that of the CCAB group (P < 0.05). However, the age had no difference between the two groups (P > 0.05). The results revealed that compared with CCAB, OPCAB receives superior short term outcome in the treatment of coronary artery disease, but the long term effectiveness needs to be explored.更多还原