【摘要】 目的观察在冠状动脉旁路移植术(CABG)中应用内窥镜采集大隐静脉的临床效果。方法 2010年3月对5例行CABG的患者采用内窥镜采集大隐静脉,观察手术情况及术后切口愈合情况,术中剩余的大隐静脉通过扫描电镜观察内膜情况。结果术中采集大隐静脉桥血管1支~3支,采集时间为25 min~42min,5例患者术后均无下肢皮肤切口感染、下肢水肿、淋巴管炎、脂肪坏死等并发症发生,平均卧床2d~3d。术后3个月,5例均无心绞痛复发及心肌梗死。扫描电镜结果显示,内窥镜采集的大隐静脉内膜完整。结论 CABG中应用内窥镜采集大隐静脉能够减少创伤,明显降低术后下肢并发症,尤适用于存在高危因素的患者。更多还原

【Abstract】 Objective To observe the clinical effects of great saphenous vein harvesting by endoscopy for coronary artery bypass grafting(CABG).Methods Great saphenous vein harvesting was performed by endoscopy in 5 patients for CABG.The process of operation and the incidence of postoperative surgical incision complications were observed.The vascular intima of remnant tissue samples of great saphenous vein were studied by scanning electron microscopy(SEM).Results The number of harvested vein grafts was 1 to 3.The endoscopic harvest time was 25 minutes to 42 minutes.There were no complications of incision infection,edema of lower extremity,lymphangitis and fat necrosis.At 3 months of postoperation,no angina pectoris and myocardial infarction were found in 5 patients.The intima in the harvested vein grafts was intact tested by SEM.Conclusion The vein harvesting by endoscopy for CABG could decrease the hurt and the incision infections,especially for patients with risk factors of incision complications.更多还原