摘要
目的探讨伴糖尿病的冠心病冠脉搭桥术(coronary artery bypass grafting,CABG)及围手术期处理.方法2000年1月～2003年6月,CABG治疗30例伴糖尿病的冠心病.结果术后发生低心排需要主动脉内气囊反搏(intra-aortic balloon pumping,IABP)2例.出现肾功能不全2例.脑血管意外长期昏迷1例,半年后死于肺部感染;术后多器官功能衰竭而死亡1例,全组死亡率为6.7%.胸部伤口感染3例,下肢伤口感染5例,占28.6%.术后出现心率失常9例,占32.1%.28例病人冠心病症状得到缓解或消失.结论伴糖尿病的冠心病的冠脉搭桥术,尽管手术死亡率及并发症稍偏高,但术前明确诊断及制订良好的手术方案,完善的围手术期处理,伴糖尿病的冠心病患者行冠脉搭桥术的治疗可取得良好效果.
Objective: To determine the coronary artery bypass grafting (CABG) and the perioperative treatment of coronary artery disease combined with diabetes mellitus. Methods: The treatment and influence of diabetes mellitus and complications of CABG were investigated in 30 consecutive patients who underwent elective CABG between January 2000 and June 2003. Results: For these patients, angina pectoris and angina equivalents disappeared or released in 28 cases during the following-up 6 to 18 months, one died of multiple system organ failure in the fifth day after operation, one suffered from the coma of cerebrovascular accident and died in half year later for the lung infection. Postoperative mortality were 6.7% (2/30). Two of them needed intra-aortic balloon pumping (IABP) for postoperative low ejection fraction. Leg and chest wound infections occur in 8 patients, wound infection rate were 28.6% (8/30). Arrhythmias took place in 9 cases after CABG. The incidence of arrhythmias were 32.1% (9/30). No patients died during operation. Conclusion: Coronary artery disease combined with diabetes mellitus showed higher mortality and complication rates during the CABG. Definitely diagnosis, satisfactory operative program and consummate perioperative treatment could improve the prognosis of the patients who suffered from coronary artery disease combined with diabetes mellitus.
出处
《中国现代医学杂志》
CAS
CSCD
2004年第16期107-109,共3页
China Journal of Modern Medicine
关键词
冠心病
冠脉搭桥术
糖尿病
围手术期
coronary artery disease
coronary artery bypass grafting
diabetes mellitus
perioperative period
