摘要
目的观察80岁以上患者行冠状动脉旁路移植术(CABG)的临床效果。方法选择2001年10月至2013年10月,在北京军区总医院心血管外科行CABG手术年龄>80岁的高龄冠心病患者60例,其中男性53例,女性7例,平均年龄(82.65±2.27)岁。急诊手术5例。体外循环下搭桥(on-pump)6例,非体外循环下搭桥(off-pump)54例。记录患者冠状动脉搭桥数量,围手术期呼吸机辅助呼吸时间、住院时间、重要脏器并发症发生率以及近期心肌缺血事件发生率。结果纳入患者平均搭桥(3.13±0.24)支,术后呼吸机辅助呼吸(10.11±4.37)h,平均住院时间(11.36±4.51)d。围手术期死亡率为5%。并发症发生率依次为胸腔积液(48.3%)、低氧及高碳酸血症(30.0%)、心房颤动(26.7%)、肾功能不全(23.3%)、低心排综合征(5.0%)等。患者出院后随访3个月,均无心肌缺血事件发生。结论做好充分的术前准备、评估及围手术期管理,80岁以上高龄患者的CABG手术依然可以取得良好效果。
Objective To observe the clinical efficacy of coronary artery bypass grafting （CABG） in aged patients over 80 with coronary heart disease （CHD）.Methods The patients （n=60, male 53 and female 7, average age=82.65±2.27） with CABG were chosen from Oct. 2001 to Oct. 2013. Among them, there were 5 with emergency CABG, 6 with on-pump CABG, and 54 with off-pump CABG. The number of coronary bypass, respirator supporting time during perioperative period, hospitalization time, incidence of vital organs complications and short-term incidences of myocardial ischemia events were recorded.Results The average number of bypass was （3.13± 0.24）, respirator supporting time after CABG was （10.11±4.37） h, average hospitalization time was （11.36±4.51） d. The perioperative mortality was 5%, and incidences of complications were, in a descending order, pleural effusion （48.3%）, hyoxemia and hypercapnia （30.0%）, atrial fibrillation （26.7%）, renal insufficiency （23.3%） and low cardiac output syndrome （5.0%）. All patients were followed up for 3 m after discharged from hospital and there were no myocardial ischemia events found.Conclusion With sufficient preoperative preparation, review and management, CABG will get good results in aged patients over 80.
出处
《中国循证心血管医学杂志》
2014年第6期724-726,732,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
冠状动脉旁路移植术
高龄老年
冠心病
Coronary artery bypass grafting
Aged patients
Coronary heart disease
