CAJ | 학술논문

目的探讨70岁以上高龄冠心病患者冠状动脉搭桥术的术式选择、临床疗效和围术期处理特点.方法选择108例≥70岁的高龄冠状动脉旁路移植术者,分为非体外循环冠状动脉旁路移植术(OPCAB)76例和体外循环下冠状动脉旁路移植术组(CCABG)32例,比较两组临床疗效、术后病死率及并发症的发生情况.结果 OPCAB组在手术病死率、围手术期心梗、呼吸衰竭、肺部并发症、神经系统并发症、急性肾衰、呼吸机使用时间明显优于CCABG组(P<0.05):结论 OPCAB在高龄冠心病患者中能明显降低因为高龄而增加的手术病死率和术后并发症,是高龄冠心病的外科治疗首选方法.
목적 탐토70세이상고령관심병환자관상동맥탑교술적술식선택、림상료효화위술기처리특점.방법 선택108례≥70세적고령관상동맥방로이식술자,분위비체외순배관상동맥방로이식술(OPCAB)76례화체외순배하관상동맥방로이식술조(CCABG)32례,비교량조림상료효、술후병사솔급병발증적발생정황.결과 OPCAB조재수술병사솔、위수술기심경、호흡쇠갈、폐부병발증、신경계통병발증、급성신쇠、호흡궤사용시간명현우우CCABG조(P<0.05):결론 OPCAB재고령관심병환자중능명현강저인위고령이증가적수술병사솔화술후병발증,시고령관심병적외과치료수선방법.
Objective To explore the characteristics of operation,curative effects and operative management in elderly patients of age older than 70 years with coronary heart disease receiving coronary artery bypass grafting.Methods 108 elderly patients of age older than 70 years with coronary heart disease were divided into two groups:OPCAB group(n = 76) and CCABG group (n = 32) The clinical curative effects, early postoperative mortality and complications of the two groups were compared and analyzed respectively. Results OPCAB group was better than CCABG group in these series(P ＜ 0.05): The early postoperative mortality (5.8%, 11.2%)、 myocardial infarction (2.9%, 10.6%), respiration failure(8.7%, 17.5%), pulmonary complications: (11.8%, 31.5%) 、complication of CNS:(1.8% ,9.8%) 、acute renal failure(1.8% ,6.2%) ,the time of intubation: (9.3 ±4.5), (25.4 ±7.5) h,ICU stay(3.1 ± 1.8) ,(7.1 ±2.9) d,hospital stay(15.5 ±8.6) ,(26.4 ±8.6)d. Conclusion OPCAB could reduce operative mortality and complication, it should be the first option for the surgery of elder patients with coronary heart disease;surgical skills and correct perioperative management were the key factors to assure surgical outcome.