摘要
目的 探讨左心室功能明显减退患者的冠状动脉旁路移植术(CABG)的外科治疗效果。方法 回顾分析2000年12月至2002年12月对心肌梗死或长期慢性心肌缺血造成心室功能明显减退的45例冠心病患者进行CABG的相关资料。结果 42例联合应用左乳内动脉与前降支吻合。人均旁路移植3.3(1～5)支,无手术死亡。术后随访2～23个月,LVEF21.3％～65％,平均(42.7±5.9)％,与术前相比提高9％～24％(P<0.05);LVEDD55.2～64.6 mm,平均(54.7±3.8)mm。与术前相比,无明显变化(P>0.05);心绞痛完全消失39例,活动耐力增加。随访期间死亡2例。结论 左心室功能明显减退的冠心病患者,CABG手术成功率和近期效果满意,生活质量明显提高。术前合理选择病例、术中充分的再血管化和良好的围手术期处理是手术成功的关键。
Objective To summarize the surgical results of patients undergone coronary artery bypass grafting(CABG) with significantly decreased left ventricular ejection fraction(LVEF). Methods Retrospectively analyzed the peri-operative data of 45-case suffering coronary artery disease (CAD) with significantly decreased LVEF because of myocardial infarction or chronic myocardial ischemia receiving CABG from Dec. 2000 to Dec. 2002. Results 42 cases received left internal mammary artery(LIMA) anastomosed to left anterior artery(LAD). The average grafts for every case were 3.3(1～5)/patient. No operative death occurred. The post-operative follow-up was 2 to 23 months, there were two deaths. The post-operative LVEF improved from 0.09 to 0.24 and compared with pre-operative LVEF showing significantly statistical differences(P<0.05), and life quality improved markedly. Conclusions The CAD patients with significantly decreased LVEF benefit from CABG. The operative and early results are satisfactory. CABG significantly improves patients' life quality. The key to successful operation is proper preoperative selection of patients, fully revascularization during operation and appropriate peri-operative management.
出处
《临床外科杂志》
2003年第5期326-328,共3页
Journal of Clinical Surgery
关键词
冠心病
左心室功能减退
冠状动脉旁路移植术
coronary artery disease
left ventricular dysfunction
coronary bypass grafting
