摘要
目的比较非体外循环心脏不停跳冠脉搭桥手术(OPCAB)与传统体外循环冠脉搭桥手术(CCAB),在围手术期缺血性心肌损伤的情况。方法2005年5～12月,对91例OPCAB和93例CCAB的围手术期患者,应用多道心电图(ECG)连续进行检测和标准化分析心电图;并在不同的时间段检测肌钙蛋白(cTnI)水平。结果OPCAB在围手术期对患者所造成缺血性心肌损伤及左室传导时间延长发生率明显低于CCAB(P<0.05);前者在围手术期内对cTnI不同时间段的测定,其结果不形成缺血性的改变的一组病人,CCAB组的cTnI最高峰值高于OPCAB组,前者相当于后者的3倍;而形成暂时性缺血性心肌损伤及心肌梗死这2组病人,CCAB组的患者cTnI的最高峰值分别高于OPCAB组。结论在CCAB比OPCAB,患者在缺血性心肌损伤方面的风险性要高。
[ Objective] To compare ischemic myocarial damage situation among peri-operational period between under on-pump and off-pump extracorporeal circulation coronary artery bypass grafting （CABG）. [ Methods] 91 cases with off-pump CABG and 93 cases with on-pump extraeorpereal circulation CABG were collected from May to December, 2005, and multichanneleleetrocardiogram （ECG） was used for the test and standardized analyses. The levels of troponin （eTnl） were tested in various time points. [ Results] The proporions of isehemic myocarial damage and prolongation of left ventricle conduction among cases with off-pump coronary artery bypass grafting （OPCAB） were significantly lower than that of cases with on-pump CABG （CCAB） （ P 〈 0.05 ）. For the tests of cTnI during perioperational period, the high-peak value among cases with no ischemic myocardial damage in the group of CCAB is higher than that in the cases of OPCAB. Among the gorup of CCAB the patients with transient ischemic damage and myocardial infarction, the peak value of cTnI is higher than that of group of OPCAB. [ Conclusion ] The risk of transient myocardial ischemia under extracorpereal circulation operation is higher than that under OPCAB .
出处
《职业与健康》
CAS
2008年第21期2344-2346,共3页
Occupation and Health
