【摘要】 目的 探讨急诊冠状动脉旁路移植术治疗高龄急性冠脉综合征的临床处理策略。方法 对21例高龄急性冠脉综合征患者采用单纯冠状动脉旁路移植术。其中体外循环下冠状动脉旁路移植18例,非体外循环下冠状动脉旁路移植3例。结果 20例患者康复出院,1例术后死于多器官功能衰竭。结论 对于高龄急性冠脉综合征患者,急诊冠状动脉旁路移植术是具有高风险的治疗措施,其实施与否取决于患者的机体状况。术前脏器功能的慎重评估和维护、术中充分的心肌再血管化以及术中、术后心脏功能等全身重要脏器功能的监测和维护是改善患者预后的重要措施。更多还原

【Abstract】 Objective To generalize clinical practice strategies of emergent coronary artery bypass grafting(CABG)in elderly patients with acute coronary syndrome(ACS).Methods All the 21 elderly patients underwent isolated CABG,including 18 patients(85.7%)with cardiopulmonary bypass(CPB)and 3 patients without CPB.Results After operation,20 patients(95.2%)recovered and discharged but1 patient died from multi-organ failure.Conclusion Emergent CABG is a risky operative procedure,which is markedly influenced by the preoperative status of the patient.Thoughtful preoperative assessment and maintenance of organ function,sufficient intraoperative myocardial revascularization,and systemic supervision and protection of vital organ functions during the intra-and post-operative period are important measures in improving prognosis.更多还原