【摘要】 目的比较内镜血管采集系统与传统切开2种手术方式行桡动脉取材术的技术特点和并发症情况。方法2012年5月~2013年5月,93例冠状动脉粥样硬化性心脏病行冠状动脉旁路移植术,其中25例(腔镜组)采用桡动脉内镜血管采集系统进行桡动脉取材,68例(切开组)采用传统切开进行桡动脉取材,经过检查修整的桡动脉用于冠状动脉旁路移植手术。对2组术中、术后情况进行比较。结果 2组均完成桡动脉取材手术。腔镜组和切开组手术时间分别为(58.2±10.4)min和(60.2±12.2)min,无统计学差异(t=-0.728,P=0.469);前臂血肿发生率分别为8.0%(2/25)和1.5%(1/68),无统计学差异(χ2=0.843,P=0.359);切口延期愈合发生率分别为0和1.5%(1/68),无统计学差异(Fisher’s检验,P=1.000);因桡神经浅支受损引起支配区感觉减退发生率分别为20.0%(5/25)和5.9%(4/68),无统计学差异(χ2=2.709,P=0.100);切开组上臂肿胀疼痛发生率17.6%(12/68),显著高于腔镜组0(Fisher’s检验,P=0.032)。结论内镜血管采集系统采集桡动脉较传统切开方式能够缩短手术切口,减少上臂肿胀疼痛,但桡神经浅支受损发生率较高,需要精细操作减少损伤。更多还原

【Abstract】 Objective To compare the technique characters and complications of endoscopic and open technique for radial artery harvesting. Methods From May 2012 to May 2013,93 patients accepted radial artery harvesting for CABG(coronary artery bypass graft). The radial arteries were harvested by using MEDOS endoscopic system in 25 patients( endoscopic group),and by traditional open technique in the remaining 68 patients(open group). Data of patients,operation,and complications were compared between the two groups. Results All the patients underwent radial artery harvesting safely. There were no significant differences between the two groups in operation time [(58. 2 ± 10. 4) min vs.(60. 2 ± 12. 2) min,t =- 0. 728,P = 0. 469],incidence of forearm hematoma [8. 0%(2 /25) vs. 1. 5%(1 /68),χ2= 0. 843,P = 0. 359],and incision complications [0 vs. 1. 5%(1 /68),P = 1. 000],respectively. The incidence rate of hypesthesia caused by injury of superficial radial nerve was 20. 0%(5 /25) in the endoscopic group and 5. 9%(4 /68) in the open group( χ2= 2. 709,P = 0. 100). The incidence rates of incision pain and forearm swelling were significantly higher in the open group than that in the endoscopic group [17. 6%(12 /68) vs. 0,Fisher’s test,P =0. 032]. Conclusion Endoscopic artery harvesting decreases the incision length and incidence of pain and forearm swelling,but bearing a relatively higher rate of superficial radial nerve paralysis.更多还原