摘要
目的对比杂交冠状动脉血运重建术(hybrid coronary.revaseularization,HCR)、传统冠状动脉搭桥手术(coronary artery bypass grafting,CABG)及经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)的术后疗效,评价HCR在冠心病治疗中的临床应用价值。方法回顾性分析已确诊冠心病并行冠状动脉造影提示冠状动脉双支或三支病变88例患者的临床资料。根据手术方式分为3组:HCR组26例,CABG组32例,PCI组30例。比较术前基本情况、手术时间、术后引流量、术后机械通气时间、术后住院天数及术后感染率等,并随访1～12个月,观察有无心肌梗死或心绞痛发作以及1年后冠状动脉和桥血管通畅情况。结果 PCI组手术时间和术后住院时间明显短于HCR组与CABG组(P<0.05),HCR组住院时间短于CABG组;CABG组术后机械通气时间明显长于HCR组,术后第1日引流量少于HCR组(P<0.05); 3组间术后3个月LVEF值、切口感染率和桥血管狭窄率差异均无统计学意义(P>0.05)。结论 HCR对于冠心病的治疗在风险、美观、预后等方面均有重要的临床价值。
Objective To evaluate the clinical value of hybrid coronary revaseularization(HCR), coronary artery bypass grafting(CABG) and percutaneous coronary intervention(PCI) in the treatment of coronary heart disease. Methods A retrospective analysis was made of the clinical data of 88 patients with confirmed coronary artery disease and coronary angiography suggesting double or triple vessel lesions of the coronary artery. According to the operation they were divided into 3 groups: 26 cases of HCR group, 32 cases of CABG group, 30 cases of PCI group. The basic conditions, operation time, drainage volume, mechanical ventilation time, postoperative hospitalization days and infection rate were compared before and after operation. The patients were followed up for 1 to 12 months to observe whether there was myocardial infarction or angina attack, and the patency of coronary artery and bridge vessels after 1 year. Results The operation time and postoperative hospitalization time of PCI group were significantly shorter than those of HCR group and CABG group, and the postoperative hospitalization time of HCR group was shorter than that of CABG group(P<0.05);the mechanical ventilation time of CABG group was significantly longer than that of HCR group, and the drainage volume on the first day after operation was less than that of HCR group, the difference was statistically significant(P<0.05). There were no significant differences in LVEF value, incision infection rate and bridging vessel stenosis rate among the three groups(P>0.05). Conclusion HCR has important clinical value in the treatment of coronary heart disease in terms of risk, aesthetics and prognosis.
作者
刘子腾
吴瑞锋
杨炜琦
张雪莲
周伯良
LIU Zi-teng;WU Rui-feng;YANG Wei-qi;ZHANG Xue-lian;ZHOU Bo-liang(Department of Cardiothoracic and Vascular Surgery,the First Central Hospital ofBaoding,Hebei Province,Baoding 071000,China)
出处
《河北医科大学学报》
CAS
2019年第6期667-670,共4页
Journal of Hebei Medical University
关键词
冠心病
心脏外科手术
对比研究
coronary disease
cardiac surgical procedures
comparative study
