摘要
目的探讨经皮冠状动脉介入术(PCI)与非体外循环冠状动脉旁路移植术(OPCABG)对冠心病患者中近远期疗效的区别。方法回顾性分析郑州市中心医院于2014年1月~2015年1月接诊的40例行PCI术的冠状动脉粥样硬化性心脏病(冠心病)患者,以及同期40例行OPCABG术的冠心病患者,比较两组气管切开、血液透析、胸骨感染、术后心房颤动及院内死亡率及手术前后左室射血分数(LVEF)的变化,并记录随访2年内不良心血管事件发生率、再入院率及死亡率。结果两组气管切开、血液透析、胸骨感染、术后心房颤动及院内死亡率方面差异无统计学意义(P>0.05),OPCABG术组再次气管内插管率高于PCI术组,差异有统计学意义[20.00%(8/20)vs.2.50%(1/40),P<0.05];两组手术前LVEF差异无统计学意义(P>0.05);手术后,两组LVEF较术前均得到改善,差异有统计学意义(P<0.05),两组手术后LVEF比较差异无统计学意义(P<0.05);在2年的随访结果显示,两组脑卒中、再次血运重建、死亡率方面差异无统计学意义(P>0.05);OPCABG组再发心肌梗死、再发心绞痛、再入院率低于PCI组,差异有统计学意义[2.63%(1/40)vs.18.92%(7/40),2.63%(1/40)vs.16.22%(16/40),10.53%(4/40)vs.40.54%(15/40),P<0.05]。结论在冠心病患者中应用PCI术和OPCABG术在近远期死亡率相似,但OPCABG术后患者远期不良心血管事件发生率更低。
Objective To discuss the difference in immediate and long-term curative effects on coronary heart disease （CHD） between percutaneous coronary intervention （PCI） and off-pump coronary artery bypass grafting （OPCABG）. Methods CHD patients （n=40） undergone PCI and CHD patients （n=40） undergone OPCABG were retrospectively analyzed in the Central Hospital of Zhengzhou City from Jan. 2014 to Jan. 2015. The status of tracheotomy, hemodialysis, sternal infection, postoperative atrial fibrillation and in-hospital mortality, and changes of left ventricular ejection fraction （LVEF） were compared, and incidence of major adverse cardiovascular events （MACE）, re-hospitalization rate and mortality were recorded in 2 groups during 2-y follow-up period. Results The difference in tracheotomy, hemodialysis, sternal infection, postoperative atrial fibrillation and in-hospital mortality had no statistical significance between 2 groups （P〉0.05）. The rate of endotracheal re-intubation was higher in OPCABG group than that in PCI group [20.00% （8/20） vs. 2.50% （1/40）, P〈0.05]. The difference in LVEF had no statistical significance between 2 groups before the operation （P〉0.05）, and LVEF was improved in 2 groups after the operation （P〈0.05）. The difference in LVEF had no statistical significance between 2 groups after the operation （P〈0.05）. The results of 2-y follow-up showed that the difference in stroke, re-revascularization and mortality had no statistical significance between 2 groups （P〈0.05）. The rates of relapse myocardial infarction [2.63% （1/40） vs. 18.92% （7/40）], relapse angina pectoris [2.63% （1/40） vs. 16.22% （16/40）] and re-hospitalization [10.53% （4/40） vs. 40.54% （15/40）] were lower in OPCABG than those in PCI group （P〈0.05）. Conclusion The immediate and long-term mortality is similar in CHD patients undergone PCI or OPCABG, while long-term incidence of MACE is lower in CHD patients undergone OPCABG.
出处
《中国循证心血管医学杂志》
2017年第12期1495-1497,1506,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
经皮冠状动脉介入
非体外循环冠状动脉旁路移植术
冠心病
不良心血管事件
Percutaneous coronary intervention
Off-pump coronary artery bypass grafting
Coronary heart disease
Major adverse cardiovascular events
