中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2010年
1期
37-40
,共4页
庄瑜%肖明第%袁忠祥%卢成宝%林雷%虞敏%毛建强
莊瑜%肖明第%袁忠祥%盧成寶%林雷%虞敏%毛建彊
장유%초명제%원충상%로성보%림뢰%우민%모건강
冠状动脉分流术%糖尿病%预后
冠狀動脈分流術%糖尿病%預後
관상동맥분류술%당뇨병%예후
Coronary artery bypass%Diabetes mellitus%Prognosis
目的 分析高龄糖尿病病人行冠状动脉旁路移植术的疗效,探讨糖尿病对高龄冠状动脉旁路手术病人的影响.方法 649例70岁以上冠脉旁路移植病人分成糖尿病组及无糖尿病组.统计分析两组术前、术中及术后资料.结果 除糖尿病组合并左主干病变较多外,两组术前病情及手术情况未见差异,术后病死率、并发症、输血等各方面差异也未见统计学意义.结论 高龄病人行冠状动脉旁路移植手术是可行的,糖尿病病人可以获得与非糖尿病者相同的治疗效果.
目的 分析高齡糖尿病病人行冠狀動脈徬路移植術的療效,探討糖尿病對高齡冠狀動脈徬路手術病人的影響.方法 649例70歲以上冠脈徬路移植病人分成糖尿病組及無糖尿病組.統計分析兩組術前、術中及術後資料.結果 除糖尿病組閤併左主榦病變較多外,兩組術前病情及手術情況未見差異,術後病死率、併髮癥、輸血等各方麵差異也未見統計學意義.結論 高齡病人行冠狀動脈徬路移植手術是可行的,糖尿病病人可以穫得與非糖尿病者相同的治療效果.
목적 분석고령당뇨병병인행관상동맥방로이식술적료효,탐토당뇨병대고령관상동맥방로수술병인적영향.방법 649례70세이상관맥방로이식병인분성당뇨병조급무당뇨병조.통계분석량조술전、술중급술후자료.결과 제당뇨병조합병좌주간병변교다외,량조술전병정급수술정황미견차이,술후병사솔、병발증、수혈등각방면차이야미견통계학의의.결론 고령병인행관상동맥방로이식수술시가행적,당뇨병병인가이획득여비당뇨병자상동적치료효과.
Objective The risk for coronary artery bypass surgery is reported to be increased with age and associated with diabetes. We examined the outcomes of coronary artery bypass grafting (CABG) in patients with diabetes who were older than 70 years of age and evaluate the effect of diabetes on CABG in those patients. Methods From March 2000 to March 2008, the data of 649 patients older than 70 years of age were collected retrospectively and divided into diabetic group or non-diabetic group based on pre-operative diagnosis. The blood glucose level of patients was maintained between 7.0 mmol/L ( 126mg/dl) and 10.0 mmoL/L ( 180 mg/dl) porioporatively. Stats 7.0 was used for statistical analysis. The t test and χ~2 test were used to determine the differences in the numerical variables and categorical variables respectively. Results No statistical differences were observed between the two groups in the baseline variables, such as age [ ( 74.78±3.67 ) years for diabetic group vs. ( 75.00±3.65 ) years for non-diabetic group, P = 0. 4877 ], female patients ( 34.76% vs. 29.22%, P =0. 1663 ), ejection fraction [ ( 57.02±10. 10 ) % vs. ( 58.49±10. 39 ) %, P = 0. 1004 ) ], myocardial infarction history (26.20% vs. 28.35%, P =0. 5795), though there were more left main diseases in the diabetic group (52.41% vs.26.41%, diabetic vs. non-diabetic, P = 0. 0000 ). The overall in-hospital mortality was 6.32% (8.02% in the diabetic group vs. 5.63% in the non-diabetic group, P = 0. 2571 ). The main causes of death were sudden respiratory and cardiac arrest,low cardiac output syndrome ( LCOS), malignant arrhythmia, respiratory failure, renal failure, central nervous system compli-cations, and multiple organ failure. Major post-operative complications were bleeding, atrial fibrillation, plural effusion and pulmonary infection. Post-operative variables, such as EF (0.59±0. 13 in the diabetic group vs. 0. 61±0.15 in the non-dia-betie group, P =0. 1807), re-revascularization due to bleeding (2. 14% vs. 4.76%, P = 0. 1232), blood transfusion (89.84% vs. 84.63%, P = 0.0820) and the administration of vasoactive agent (21.93% vs. 27.71%, P= 0. 1286),were found no significant difference between the two groups. Conclusion Conclusions The early outcomes of CABG in aged patients are acceptable. The surgical consequences in diabetic patients may be similar to those in non-diabetic patients.