|本期目录/Table of Contents|

[1]祁泉 李昕 刘俊 李波霞 董帅 陈万强 宋兵.分站式杂交冠状动脉血运重建治疗多支病变的疗效研究[J].国际心血管病杂志,2019,06:368-372.
　QI Quan,LI Xin,LIU Jun,et al.Efficacy of 2-staged hybrid coronary revascularization in the treatment of multivessel coronary artery disease[J].International Journal of Cardiovascular Disease,2019,06:368-372.
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分站式杂交冠状动脉血运重建治疗多支病变的疗效研究(PDF)

《国际心血管病杂志》[ISSN:1006-6977/CN:61-1281/TN]

期数:
2019年06期
页码:
368-372
栏目:
临床研究
出版日期:
2019-12-31

文章信息/Info

Title:
Efficacy of 2-staged hybrid coronary revascularization in the treatment of multivessel coronary artery disease
作者:
祁泉 李昕 刘俊 李波霞 董帅 陈万强 宋兵
730000 兰州大学第一医院心血管外科(祁泉,李昕,董帅,宋兵),药剂科(李波霞),康复科(陈万强); 200025 上海交通大学医学院附属瑞金医院(刘俊)
Author(s):
QI Quan1;  LI Xin1;  LIU Jun2;  LI Boxia3;  DONG Shuai1;  CHEN Wanqiang4;  SONG Bing1
1. Department of Cardiac Surgery, The First Hospital of Lanzhou University, Gansu 730000; 2. Department of Cardiac Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200050; 3. Department of Pharmacy, The First Hospital o
关键词:
冠状动脉粥样硬化性心脏病;  分站式冠状动脉杂交技术;  非体外循环冠状动脉旁路移植术;  经皮冠状动脉介入术
Keywords:
Coronary artery disease;  Hybrid coronary revascularization;  Off-pump coronary artery bypass;  Percutaneous coronary intervention
分类号:
-
DOI:
10.3969/j.issn.1673-6583.2019.06.011
文献标识码:
-
摘要:
目的:对比分站式杂交冠状动脉血运重建(HCR)与常规非体外循环冠状动脉旁路移植术OPCAB治疗多支病变的疗效。方法:收集同一时期内冠状动脉粥样硬化性心脏病(冠心病)多支病变患者61例,经心内科、心外科联合会诊评估病情后,分为行分站式HCR患者27例(HCR组)和行OPCAB患者34例(OPCAB组)。收集并比较2组患者的基线资料、术前检查结果、术前SYNTAX评分和欧洲心血管手术危险因素评分系统(EuroSCORE)评分、手术资料、术后情况、住院时间和花费、术后院内并发症。所有患者随访1年,记录主要不良心脑血管事件(MACCE)和次要不良事件。结果:2组患者的基线特征基本一致。HCR组的手术时间、切口大小、出血量均明显小于OPCAB组(P<0.05),2组最终再血管化的血管数量差异无统计学意义(P>0.05)。HCR组的24 h和48 h胸腔引流量、胸腔引流带管时间、红细胞及血浆用量、呼吸机辅助呼吸时间、ICU时间和总住院时间均明显低于OPCAB组(P<0.05)。OPCAB组术后各类并发症的发生率高于HCR组(P<0.05),2组均无院内死亡。所有患者术后最长随访1年,两组MACCE和次要不良事件发生率的差异无统计学意义(P>0.05)。结论:对于冠心病多支病变患者,分站式HCR有更好的围术期表现,以及不劣于OPCAB的花费及早期随访结果。
Abstract:
Objective:To compare the efficacy of 2-staged hybrid coronary revascularization(HCR)with conventional off-pump coronary artery bypass(OPCAB)in the treatment of multivessel coronary artery disease(CAD).Methods:A total of 61 patients with multivessel coronary artery disease were included, and according to the surgical procedures which were selected on the basis of patient's condition they were individed into two grougs, namely 2-staged HCR group(n=34)and OPCAB group(n=34). Baseline data, preoperative examination results, preoperative SYNTAX score and European system for cardiac operative risk evaluation(EuroSCORE)score, surgical data, postoperative status, length and cost of hospitalization and postoperative complications were collected. All the patients were followed up for the major adverse cardiovascular and cerebrovascular events(MACCE)and minor adverse events within one year.Results:The operation time, incision size and blood loss in the 2-staged HCR group were significantly lower than those in the OPCAB group(P<0.05). There was no statistical difference in the number of revascularized vessels between two groups(P>0.05). Compared with the OPCAB group, the OPCAB group had a significantly larger thoracic drainage volume and dose of erythrocyte and plasma was smaller; and retention time of drainage tube, time of ventilator-assisted breathing, ICU and hospital stay time were shorter in the HCR group, with lower incidence rate of postoperative complications(all P<0.05). No nosocomial death was found in two groups. All patients were followed up for one year after surgery and there was no difference between two groups for the incidence of MACCE and secondary adverse events(P>0.05).Conclusions:For patients with multivessel CAD, 2-staged HCR has better perioperative performance than OPCAB, and the costs and early follow-up results is not inferior to OPCAB.

参考文献/References

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备注/Memo

备注/Memo:
基金项目:甘肃省卫生行业科研计划项目(GSWSKY2018-49); 甘肃省自然科学基金(18JR3RA349); 兰州大学第一临床医学院“卓越计划”(20180060153); 甘肃省青年科技计划项目(1506RJYA264)
作者单位:730000 兰州大学第一医院心血管外科(祁泉,李昕,董帅,宋兵),药剂科(李波霞),康复科(陈万强); 200025 上海交通大学医学院附属瑞金医院(刘俊)
通信作者:宋兵,Email:673218767@qq.com
更新日期/Last Update: 2019-12-27