摘要
目的总结应用内窥镜采集静脉（endoscopic vein harvesting，EVH）技术获取大隐静脉（greater saphenous vein，GSV）进行冠状动脉旁路移植手术（coronary artery bypass grafting，CABG）后1年随访结果，评估采用EVH技术的手术效果。方法2009年5月至2010年5月，136例患者应用EVH取GSV进行的非体外循环冠状动脉旁路移植术（off-pump coronary artery bypass grafting，OPCABG），112例开放静脉获取术（open vein harvesting，OVH）取GSV进行的OPCABG。评估7l例应用EVH和64例传统手术切口取GSV行OPCABG患者1年随访结果，比较两组患者手术情况、下肢切口并发症、1年后移植血管通畅率以及心理状况。结果EVH组与OVH组比较，在创面大小、伤口恢复及美观化、伤口感染率、神经功能影响、二次清创缝合率以及下肢切口总体并发症发生率等方面具有明显优势。比较两组患者术后1年移植血管通畅率，EVH组动脉移植血管通畅率96．8％，静脉移植血管通畅率85．7％；OVH组动脉移植血管通畅率94．9％，静脉移植血管通畅率86．4％。两组随访结果中心绞痛再发率、动脉移植通畅率、静脉移植通畅率差异均无统计学意义。EVH组患者心理状况调查结果优于OVH组。结论与常规OVH方法相比较，EVH技术对获取移植静脉具有更多优势，通过在采集前对患者进行部分肝素化等更具保护移植静脉材料的方法，EVH组也保持了满意的移植血管1年期通畅率。
Objective To summarize the one-year follow-up clinical result of patients undergoing Endoscopic vein harvest （EVH） technology to collect greater saphenous vein（GSV） in coronary artery bypass operation （CABG）, and to assess the related factors influencing the outcome.＇ Methods 248 patients underwent off-pump coronary artery bypass grafting （OPCAG） from May 2009 to May 2010. Among these patients,136 patients with coronary artery disease received EVH technology to gain GSV, and 112 patients received conventional open vein harvesting （OVH）. Then 71 EVH （group 1 ） patients and 64 OVH （ group 2） patients had one-year follow-up analysis. We compared and evaluated the data of two groups about operation information, lower limb wound complication, bridge blood vessels patency rate, and psychologic status. Results The date of wound surface size, wound healing and appearance , wound infection rate, the second debridement rate and the overall lower limb wound complication rate show that EVH was better than OVH. After one-year follow-up, we contrasted the patency rale of bridge blood vessels between two.groups. The patency rate of arterial bridge blood vessels was 96.8% （venous bridge blood vessels was 85.7% ） in group of EVH when we followed up 63 patients ; while the patency rate of arterial bridge blood vessels was 94.9% （ venous bridge blood vessels was 86.4% ） in group of OVH that we followed up 59 patients. We compared the outcome between two groups, and found that there were no statistical significance in angina recurrence rate, patency rate of venous graft and pateney rate of arterial graft. But the psychologic status was dif（erent, the EVH group was better than OVH group. Conclusion Compared to OVH, EVH technique has more advantages. Through taking a more secure method in the collection process of the bridging vein material, EVH group also maintained a satisfactory one-year graft pateney rate.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2012年第1期28-31,共4页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
非体外循环
大隐静脉
冠状动脉
随访研究术
Greater saphenous vein Coronary artery bypass, off-pump Follow-up studies Endoscopy
