[1]李晓峰,张伟华,罗 鸿,等.冠脉旁路移植术中两种乳内动脉游离方法的临床效果对比[J].郑州大学学报(医学版),2017,(03):349-352.[doi:10.13705/j.issn.1671-6825.2017.03.026]
 LI Xiaofeng,ZHANG Weihua,LUO Hong,et al.Two internal mammary artery free method by coronary artery bypass grafting in clinical research[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2017,(03):349-352.[doi:10.13705/j.issn.1671-6825.2017.03.026]
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冠脉旁路移植术中两种乳内动脉游离方法的临床效果对比()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2017年03期
页码:
349-352
栏目:
应用研究
出版日期:
2017-05-15

文章信息/Info

Title:
Two internal mammary artery free method by coronary artery bypass grafting in clinical research
作者:
李晓峰张伟华罗 鸿马 宁臧素华李豪威张 新#
郑州大学第一附属医院心外科 郑州 450052
Author(s):
LI XiaofengZHANG WeihuaLUO HongMA NingZANG SuhuaLI HaoweiZHANG Xin
Department of Cardiovascular Surgery,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052
关键词:
冠脉旁路移植术 乳内动脉 骨骼化法 带蒂法 冠心病
Keywords:
coronary artery bypass grafting internal mammary artery skeletonized pedicled coronary heart disease
分类号:
R654.2
DOI:
10.13705/j.issn.1671-6825.2017.03.026
摘要:
目的:对比分析冠状动脉旁路移植术(CABG)中带蒂法和骨骼化法游离乳内动脉对术后近期结果的影响。方法:选取单纯行CABG的冠心病患者526例为研究对象,分为带蒂法游离乳内动脉组(262例)和骨骼化法游离乳内动脉组(264例),分析两组围术期相关指标、主要术后并发症及随访术后桥血管通畅率等。结果:526例患者全部顺利完成手术。带蒂法游离乳内动脉组动脉桥血流量为(22.8±7.8)mL/min,游离时间为(18.1±5.5)min,获得乳内动脉长度(13.5±0.8)cm; 骨骼化法游离乳内动脉组分别为(41.6±8.3)mL/min、(32.5±6.8)min和(15.8±0.9)cm,差异均有统计学意义(P<0.05)。带蒂法游离乳内动脉组手术总时间(245±21)min,围术期死亡4例,围手术期心梗12例; 骨骼化法游离乳内动脉组分别为(252±18)min、5例和10例,两组各有1例胸骨不愈合,差异均无统计学意义(P>0.05)。术后随访3~12个月,两组1 a内动脉桥通畅率均为99.6%。结论:冠脉旁路移植术中,采取骨骼化与带蒂法游离乳内动脉对术后近期效果无明显差异。
Abstract:
Aim: To compare the postoperative effect of pedicled and skeletonized free internal mammary artery after coronary artery bypass grafting(CABG).Methods: A total of 526 patients with coronary heart disease who underwent CABG were selected and randomly allocated into two groups, among them, 262 cases in group P underwent surgery with the use of pedicle internal mammary artery, and 264 cases in group S underwent surgery with the use of skeletonized internal mammary artery. The main complications, perioperative related indicators and postoperative follow-up records of graft patency rate of the 2 groups were compared.Results: The surgery of 526 cases were successfully completed. The artery blood flow during operation in group P was(22.8±7.8)mL/min and that in group S was(41.6±8.3)mL/min; the time for freeing internal mammary artery was(18.1±5.5)min in group P and(32.5±6.8)min in group S; the length of free internal mammary artery was(13.5±0.8)cm in group P and(15.8±0.9)cm in groups; and there were significant differences in the above parameters between the 2 groups(P<0.05). The total time of surgery for group P was(245±21)min and that for group S was(252±18)min; perioperative death in group P and group S was 4 cases and 5 cases; there were 12 cases and 10 cases in group P and group S during perioperative period occured myocardial infarction; there was 1 case in both groups developed sternal nonunion; the difference between the 2 groups had no statistical significance(P>0.05). The patients were followed up for 3 to 12 months, and the patency rate of artery graft for the 2 groups within 1 years was both 99.6%.Conclusion: In CABG, the skeletonized and pedicled method of obtaining free internal mammary artery have no significant effects on recent postoperative results.

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备注/Memo

备注/Memo:
#通信作者,男,1969年12月生,博士,教授,主任医师,研究方向:心脏大血管外科基础及临床应用,E-mail:zhangxin615302@163.com
更新日期/Last Update: 2017-05-20