【摘要】 目的总结40例老年冠状动脉旁路移植术(CABG)无死亡的临床体会,比较非体外循环不停跳冠状动脉搭桥术(OPCAB)和体外循环下冠状动脉旁路移植术(CCABG)后的早中期结果。方法回顾性地分析2003年9月至2006年6月连续完成的40例老年冠状动脉搭桥术。患者年龄65～85岁,其中12例CCABG,28例OPCAB。结果患者无手术死亡。OPCAB组3支病变26/28,CCABG组3支病变10/12,其中1例同期室壁瘤切除,1例同期主动脉瓣置换。平均旁路移植支数为(3.4±0.8)支。患者随访率100%,随访时间1～34个月。随访期间仅有1例术后1个月剧烈活动后出现心绞痛,其他无任何症状。结论对于选择性病例,只要掌握手术适应证,OPCAB和CCABG均可以获得较满意的早中期效果。更多还原

【Abstract】 Objective To summarize the results and experience of no oprative mortality of consecutive 40 senile cases with coronary artery disease for coronary artery bypass grafting. To compare early and midterm result of off-pump and on-pump coromary artery bypass CAB. Methods To retrospectively analyse the clinical experience and to follow up early and midterm effect, between Sep. 2003 and Jun. 2006, continuous 40 senile patients under went coronary artery bypass grafting. Male 32, female 8,conventional coronary artery bypass grafting(CCABG) in 12 cases, off-pump coronary artery bypass grafting(OPCABG) in 28 cases. Results There are no operative mortality in two groups.Triple vessel disease was 26/28 in off-pump CAB Group,10/12 in on-pump CABG,in 1 case combined with aortic valve replacement,in 1 case combined with left ventricul ananeurysm resection.A mean of grafting blood vessel numbers was 3.4±0.8. The proportion of two groups followed up was 100 percent. The term of followed up was 1-34 months. All patients recovered and discharged.Only 1 case with severe angina cordis postoperation 1 month after strenuous exercise. Conclusion Reasonable patient choice, advanced operative methods, excellent myocardial protection and perioperative treatments are important factors, the efficacy and safety of coronary artery bypass grafting are satisfactory. Off-pump CABG and on-pump CABG can achieve satisfactory early and midterm effects in the selected patients.更多还原