【摘要】 目的探讨采用不同乳内动脉游离法行冠状动脉旁路移植术对冠心病患者围术期相关指标及术后并发症的影响。方法选取2015年5月—2017年6月本院收治的行冠状动脉旁路移植术的143例冠心病患者,按照术中不同乳内动脉游离方法分为研究组74例和对照组69例。对照组采用带蒂游离法获取乳内动脉,研究组采用骨骼化游离法获取乳内动脉。对比分析两组围术期相关指标、术后并发症及术后1年随访情况。结果研究组乳内动脉血流量多于对照组,游离乳内动脉长度明显长于对照组,差异均有统计学意义(P<0.01)。研究组术后胸腔积液量明显少于对照组,重症监护病房停留时间明显短于对照组,差异均有统计学意义(P<0.01)。研究组术后并发症发生率为5.41%明显低于对照组的15.94%(P<0.01)。术后随访1年,两组死亡、再发心肌梗死、再发心绞痛、脑卒中发生率及动脉桥通畅率比较差异均无统计学意义(P>0.05)。结论骨骼化游离法应用于冠状动脉旁路移植术获取乳内动脉可有效改善冠心病患者围术期相关指标,降低术后并发症发生率,是一种较为安全且有效的方法。更多还原

【Abstract】 Objective To investigate the effect of different free internal mammary artery(IMA) graft on perioperative related indexes and postoperative complications in patients with coronary heart disease(CHD) undergoing coronary artery bypass graft(CABG). Methods A total of 143 patients with coronary artery disease who underwent CABG in our hospital from May 2015 to June 2017 were selected in this study. According to the different free IMA graft, they were divided into research group(n=74) and control group(n=69). In the control group, the IMA was obtained by free pedicled graft, and in the research group, the IMA was obtained by skeletonization The perioperative related indexes, postoperative complications and follow-up within 1 year were compared between the two groups. Results The blood flow of the IMA of the research group was higher than that of the control group, and the free IMA was significantly longer than that of the control group(P<0.01). The amount of pleural effusion in the research group was significantly lower than that in the control group, and the length of ICU stay was significantly shorter than that in the control group(P<0.01). The incidence of postoperative complications in the research group was 5.41%, which was significantly lower than that(15.94%) in the control group(P<0.01). There was no significant difference in the incidence of mortality, recurrent myocardial infarction, recurrent angina pectoris, stroke and patency rate of arterial bridge at 1-year follow-up between the two groups(P>0.05). Conclusion Skeletonization for CABG to obtain the IMA can effectively improve the perioperative related indexes of patients with CHD and reduce the incidence of postoperative complications. It is a safe and effective method.更多还原