【摘要】 目的　尝试和探讨非体外循环下冠状动脉搭桥手术的方法 ,可行性和安全性。方法　 8例病人在无体外循环支持下进行搭桥手术 ,共搭桥 11支 ,平均 1 37支 ,其中左前降支 (LAD) 8支 ,对角支 (DIA) 2支 ,右冠状动脉 (RCA) 1支。手术均在全身麻醉 ,正中纵劈胸骨切口 ,用MedtronicOctopusⅡ固定器辅助下进行。结果　本组 8例病人均安全顺利地施行了手术并康复出院 ,手术大大简化 ,住ICU和住院时间均大大缩短 ,病人恢复快 ,痛苦少 ,手术创伤小 ,手术风险低 ,可收到与体外循环下冠状动脉搭桥的同样效果 ,术后心排出量 (CO)由手术前 (3 5± 0 3)L/min上升到 (5 2±1 2 )L/min ,心脏指数 (CI)由手术前的 (2 0± 0 3)L/(min·m2 )上升到 (3 1± 0 7)L/(min·m2 )。结论　非体外循环下冠状动脉搭桥术对某些冠心病病人的手术是安全可行的 ,尤其适用于单支或两支病变、心功能差、EF低和高龄病人。可降低术后死亡率和并发症的发生 ,且费用低。更多还原

【Abstract】 Objective To try and inquire into the "off-pump" coronary artery bypass grafting (OPCAB) techniques applicability and safety. Methods 8 off-pump beating heart operations were performed at our hospital successfully with the Medtronic Octopusil stabilizer. 13 grafts (average 1.44 grafts per patient) have been done in which 9 left anterior descending arteries (LAD), three diagonal arteries (DIA) and one right coronary artery (RCA). Results All the 8 patients had very smooth postoperative procedure and discharged at 12 to 15 days after the operation. The intensive care unit stay only one or two days which is much shorter than the usually way. Cardiac output increased from (3.5±0.3) L/min. Preoperation to (5.2±1.2) L/min. Postoperation. Cardiac index increased from (2.0±0.3) L/(min·m 2). Preoperation to (3.1±0.7) L/(min·m 2). Postoperation.Conclusion The 8 cases results suggest that the OPCAB is a safe, applicable, minimally invasive, less risk, and sample technique. It fits the need for the aged low ejection fraction, high risk patient. The technique is also cost effective.更多还原