70 例冠状动脉旁路移植术临床分析 - 第三军医大学学报.doc

350例冠状动脉旁路移植术临床分析 陈劲进 肖颖彬 陈柏成 陈林 王学锋 王咏 程伟 马瑞彦（400037 重庆 第三军医大学新桥医院全军心外科中心） 摘要：目的　总结分析冠状动脉旁路移植术(CABG) 治疗冠心病的疗效和经验。方法　从2002年1月至2012年6月我们共完成 CABG 350例，包括男262例，女88例，平均62.3岁。均在中低温体外循环下完成手术。其中18例同期行室壁瘤切除术。　结果　本组平均搭桥3.2根。围手术期死亡8例,死亡率2.3%。 死亡原因包括:发生严重肺部感染、呼吸功能衰竭导致多器官功能衰竭6例,术后发生室颤抢救无效1例，围术期急性心肌梗死1例。随访238例, 随访时间3个月～9年, 远期死亡3例,死亡原因不明。余病人心功能均明显改善,170例心绞痛症状完全缓解,68例症状较前减轻。　结论　常规中低温体外循环下CABG是治疗冠心病安全、有效的方法。 　 关键词： 冠状动脉旁路移植术；体外循环；心脏外科手术 Coronary Artery Bypass Grafting : A Report of 350 Cases Chen Jinjin，Xiao Yingbin ，Chen Baicheng，Chen Lin， Wang Xuefeng， Wang Yong，Chen Wei, Ma Ruiyan (Department of Cardiovascular Surgery， Xinqiao Hospital， Third Military Medical University， Chongqing 400037， China) AbstractObjective To summarize the clinical experiences of coronary artery bypass grafting (CABG) in the treatment of coronary artery disease. Methods CABG were performed From January 2002 to June 2012 on 350 consecutive cases , including 262 male and 88 female with a mean age of 62.3 years. All the operation were performed under cardiopulmonary bypass (CPB ) with moderate hypothermia. Left ventricular aneurysm plasty operation were performed in 18 patients. Results The mean number of grafts was 3.2 , There were 8 deaths with a mortality of 2.3 % . 6 patients died of multiple organ failure caused of severe lung infection and respiratory failure, 1 patients died of ventricular fibrillation after operation, 1 patients died of acute myocardial infarction. Postoperative follow up was carried out on 238 cases, follow up time was 3 months to 9 years. Three of them died of unknow causes. The heart function of the rest was significantly improved.170 patients were free of angina pector. 68 patients’s symptom got better. Conclusions CABG performed under cardiopulmonary bypass (CPB ) with moderate hypothermia is safe and effective for treatment of coronary artery disease. Key words：Coronary artery bypass grafting 　 cardiopulmonary bypass 　 　Cardiac surgical procedures ,冠状动脉旁路移植术( cornary artery