摘要
目的总结内窥镜采集大隐静脉在冠状动脉旁路移植术（CABG）中的应用结果。方法2013年7月至2014年10月手术治疗的500例单纯冠状动脉旁路移植术病例，其中250例接受内窥镜大隐静脉采集（EVH），250例接受开放静脉采集（OVH）。对比两组采集手术的结果和住院期间的并发症。结果两组均顺利完成手术。获取静脉长度和静脉损伤差异无统计学意义（P〉0．05）。两组住院病死率相同。在获取静脉时间、切口长度、腿部切口的并发症方面EVH组较OVH组有明显优势，差异有统计学意义（P〈0．01）。EVH组术后早期下地活动时间和住院时间均明显优于OVH组（P〈0．05）。EVH组术后疼痛评分和患者满意度具有明显优势，差异有统计学意义（P〈0．05）。结论EVH可以满足CABG对移植静脉血管的手术要求。与OVH相比，EVH可以显著减少腿部并发症，并提高患者对手术的满意度。
Objective To evaluate clinical results of endoscopic vein harvesting（EVH） in patients who underwent coro- nary artery bypass grafting（CABG）. Methods From July 2013 to October 2014, 500 patients who underwent isolate CABG in our institution were divided into two groups： EVH group （n = 250 ）and open vein harvesting（ OVH ）group （n = 250 ）. The surgi- cal result and perioperative complications were compared between the two groups. Results The procedures were completed successfully in all the patients in both groups. There was no significant difference existed in the length of the harvested vein and vein injury between the two groups（P 〉 0. 05 ）. Similar results were obtained in the in-hospital mortality. Compared to group OVH, group EVH showed significantly shorter harvesting time, smaller incision, and lower rates of perioperative leg complica- tions （ P 〈 0.01 ）. Group EVH had a less bed staying time after operation and a shorter post-operation hospital stay（ P 〈 0.05 ）. EVH group achieved an improved patient satisfaction and postoperative pain when compared with OVH in CABG（ P 〈 0.05 ）. Conclusion EVH can provide adequate vein graft for CABG, and also significantly reduce wound related complications when compared with OVH. EVH is recommended for vein harvesting to improve patient satisfaction.
出处
《中华胸心血管外科杂志》
CSCD
2016年第8期467-469,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
