不停跳冠脉搭桥心肌保护技术在冠脉搭桥合并瓣膜手术中的应用
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摘要
回顾性分析39例冠脉搭桥(CABG)合并瓣膜手术中,应用不停跳冠脉搭桥(OPCABG)心肌保护技术的临床效果。所有患者手术顺利,1例患者术后血压维持不佳,主动脉内球囊反搏(IABP)辅助后恢复良好,余监护室及病房生命体征平稳、循环稳定,均顺利康复出院,术后平均随访3个月心功能(NYHA)明显改善。在CABG合并瓣膜手术中应用OPCABG心肌保护技术具有确切、良好的临床效果。
The myocardial protection technique of off-pump coronary artery bypass grafting( OPCABG) has been applied to the coronary artery bypass grafting( CABG) with heart valve surgery. This study is aimed at determining its clinical effect. A retrospective analysis design was adopted. 39 patients were recruited. All patients' surgeries went smoothly but one,whose blood pressure was in poor control after surgery and then returned to normal after assisted with intra-aortic balloon counterpulsation( IABP). Others had stable vital signs and circulation. Finally,all patients discharged safely. Significant improvement can be seen during 3 months' follow-up. Applying OPCABG to CABG with heart valve surgery has been proved effective in clinic.
The myocardial protection technique of off-pump coronary artery bypass grafting( OPCABG) has been applied to the coronary artery bypass grafting( CABG) with heart valve surgery. This study is aimed at determining its clinical effect. A retrospective analysis design was adopted. 39 patients were recruited. All patients' surgeries went smoothly but one,whose blood pressure was in poor control after surgery and then returned to normal after assisted with intra-aortic balloon counterpulsation( IABP). Others had stable vital signs and circulation. Finally,all patients discharged safely. Significant improvement can be seen during 3 months' follow-up. Applying OPCABG to CABG with heart valve surgery has been proved effective in clinic.
引文
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[11]Nakamura K,Hashimoto K,Okuyama H,et al.Off-pump coronary artery bypasssurgery in patients with mitral regurgitation[J].Kyobu Geka,2005,58(12):1057-62.
[2]Lytle B W,Cosgrove D M,Gill C C,et al.Mitral valve replacement combined with myocardial revascularization:early and late results for 300 patients,1970 to 1983[J].Circulation,1985,71(6):1179-90.
[3]Stble E,Bergstrm R,Nystrm S O,et al.Early results of aortic valve replacement with or without concomitant coronary artery bypass grafting[J].Circulation,1991,25(1):29-35.
[4]徐志云,邹良建,韩林,等.非缺血性心脏瓣膜疾病合并冠心病同期手术治疗的临床分析[J].中国胸心血管外科临床杂志,2008,15(4):241-4.
[5]艾陈晨,董逸飞,王云.瓣膜病合并冠心病体外循环中的心肌保护[J].中国当代医药,2012,19(9):35-5.
[6]Hu Z,Yan Z,Wang H,et al.Comparative analysis of preservation method and intermittent perfusion volume on the expression of endothelial and inflammatory markers by coronal artery and myocardium in porcine donor hearts[J].ASAIO J,2014,60(6):681-7.
[7]Symons J A,Myles P S.Myocardial protection with volatile anaesthetic agents during coronary artery bypass surgery:a meta-analysis[J].Br J Anaesth,2006,97(2):127-36.
[8]Hausenloy D J,Boston-Griffiths E,Yellon D M.Cardioprotection during cardiac surgery[J].Cardiovasc Res,2012,94(2):253-65.
[9]王圣,程兆云,赵子牛,等.顺逆灌结合桥灌技术在重症冠心病搭桥术中的临床应用[J].中国动脉硬化杂志,2015,23(1):87-89.
[10]高国栋,胡强,胡金晓,等.体外循环冠状动脉搭桥术中不同停跳液灌注方法的心肌保护作用[J].中国组织工程研究,2015,19(7):1112-6.
[11]Nakamura K,Hashimoto K,Okuyama H,et al.Off-pump coronary artery bypasssurgery in patients with mitral regurgitation[J].Kyobu Geka,2005,58(12):1057-62.