摘要
目的对比观察采用桡动脉(RA)和大隐静脉(SVG)分别联合左乳内动脉(LIMA)实施冠状动脉旁路移植术(CABG)的多支冠状动脉病变患者术后1年桥血管通畅情况。方法接受CABG治疗的多支冠状动脉病变患者67例,根据手术方式不同分为RA组、SVG组,其中RA组35例患者选用LIMA+RA作为桥血管进行CABG治疗,SVG组32例患者选用LIMA+SVG作为桥血管CABG治疗。两组患者均在体外循环下完成CABG。收集并比较两组患者术后住院时间、ICU监护时间、术后并发症(肺部感染、胸骨哆开、肾功能不全、二次探查止血)、术肢伤口长度及术肢伤口愈合情况等。术后1年行冠脉CTA与心脏彩超检查,评估患者桥血管早期通畅情况,收集并比较两组患者心脑血管事件(心绞痛、心肌梗死、脑梗死、二次血运重建)发生情况、术后生存情况、术肢并发症的发生情况。结果两组患者均顺利完成体外循环下CABG手术。RA组患者共涉及桥血管76支,其中LIMA桥血管35支、RA桥血管41支。SVG组共涉及桥血管97支,其中LIMA桥血管32支、SVG桥血管65支。RA组患者的术后住院时间、出现肺部感染的概率、术肢伤口长度、出现术肢伤口愈合不良的概率均低于SVG组(P均<0.05)。两组患者LIMA桥血管均通畅。RA组术后1年RA桥血管通畅率(85.4%)与SVG组SVG桥血管通畅率(87.6%)相比差异无统计学意义(P>0.05),但RA组RA桥血管与SVG组SVG桥血管相比更易出现“线样征”(P<0.05)。两组患者不良心脑血管事件发生情况、术后生存情况、术肢并发症的发生情况差异无统计学意义(P均>0.05)。结论RA桥血管、SVG桥血管在多支冠状动脉病变患者CABG术后1年的通畅率均较高,与SVG组患者相比,RA组患者的术后住院时间更短、肺部感染等术后并发症更少、更易出现“线样征”。
Objective To observe and compare the patency of bridging vessels in patients with multiple coronary artery diseases who underwent coronary artery bypass grafting(CABG) with left internal mammary artery(LIMA) combined with radial artery(RA) versus saphenous vein graft(SVG) one year after operation.Methods Sixty-seven patients with multi-vessel coronary artery disease treated by CABG were divided into the RA group and SVG group according to the mode of operation.Thirty-five patients in the RA group received CABG with LIMA+RA as bridging vessels,and 32 patients in the SVG group received CABG with LIMA+SVG as bridging vessels.The postoperative hospital stay,ICU monitoring time,postoperative complications(pulmonary infection,multiple opening of sternum,renal insufficiency,and secondary exploration to stop bleeding),wound length,and wound healing of the operative limb were collected and compared between the two groups.One year after operation,coronary CTA and color Doppler echocardiography were performed to evaluate the early patency of bridging vessels.The incidence of cardio-cerebrovascular events(angina pectoris,myocardial infarction,cerebral infarction,and secondary revascularization),postoperative survival and operative limb complications were collected and compared between the two groups.Results Patients in both groups successfully completed CABG under cardiopulmonary bypass.A total of 86 bridging vessels were involved in the RA group,including 35 LIMA bridging vessels and 51 RA bridging vessels.A total of 97 bridging vessels were involved in the SVG group,including 32 LIMA bridging vessels and 65 SVG bridging vessels.The postoperative hospital stay,the probability of pulmonary infection,the length of operative limb wound and the probability of poor wound healing in the RA group were lower than those in the SVG group(all P<0.05).LIMA bridging vessels were unobstructed in both groups.One year after operation,there was no significant difference in the patency rate between the RA bridging vessels(84.3%) in the RA gr
作者
蔡超
刘戈
亓先杰
施超
CAI Chao;LIU Ge;QI Xianjie;SHI Chao(Department of Heart Surgery,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)
出处
《山东医药》
CAS
2022年第9期32-36,共5页
Shandong Medical Journal
基金
蚌埠医学院转化医学重点专项(BYTM2019041)。
关键词
冠状动脉病变
冠状动脉旁路移植术
桥血管
桡动脉
大隐静脉
血管通畅率
线样征
coronary artery disease
coronary artery bypass grafting
bridging vessels
radial artery
saphenous vein graft
vascular patency rate
linear sign
