心血管外科杂志（电子版）
心血管外科雜誌（電子版）
심혈관외과잡지（전자판）
Journal of Cardiovascular Surgery(Electronic Edition)
2014年
2期
66-69
,共4页
徐荣伟%叶志东%刘鹏%樊雪强%陈洁%田宇%王非%林凡%杨煜光%钱松屹%王凤林
徐榮偉%葉誌東%劉鵬%樊雪彊%陳潔%田宇%王非%林凡%楊煜光%錢鬆屹%王鳳林
서영위%협지동%류붕%번설강%진길%전우%왕비%림범%양욱광%전송흘%왕봉림
颈动脉内膜切除术%冠状动脉旁路移植术,非体外循环%手术并发症
頸動脈內膜切除術%冠狀動脈徬路移植術,非體外循環%手術併髮癥
경동맥내막절제술%관상동맥방로이식술,비체외순배%수술병발증
Endarterectomy,carotid%Coronary artery bypass,off-pump%Intraoperative complications
目的评价同期行颈动脉内膜剥脱术（CEA）联合冠状动脉搭桥术（CABG）治疗颈动脉与冠状动脉狭窄并存疾病的安全性和临床疗效。方法总结2000年1月至2013年8月我科收治的34例并存颈动脉与冠状动脉狭窄并均实施了同期CEA联合CABG手术患者的临床资料，其中男21例，女13例；年龄54～85岁，平均（70±6）岁。所有患者术前均行冠状动脉和颈动脉造影明确诊断，其中冠状动脉左主干病变6例，3支血管病变17例，2支血管病变11例。先行CEA再行CABG者33例，1例先行CABG再行CEA。Off-Pump CABG 26例，On-Pump 8例。 CEA全部为单侧，术中均使用颈动脉转流管，并采用人工血管补片加宽颈动脉切口。结果无手术死亡病例，无围术期心肌梗死、脑血管意外。1例于术后1个月因下肢动脉硬化闭塞症行右侧股-腘动脉人工血管搭桥术。术后随访6～84个月，无心脑血管事件发生。结论同期行CEA联合CABG处理颈动脉与冠状动脉狭窄并存疾病安全、有效，可有效预防围术期心脑血管并发症的发生，中期随访效果满意。
目的評價同期行頸動脈內膜剝脫術（CEA）聯閤冠狀動脈搭橋術（CABG）治療頸動脈與冠狀動脈狹窄併存疾病的安全性和臨床療效。方法總結2000年1月至2013年8月我科收治的34例併存頸動脈與冠狀動脈狹窄併均實施瞭同期CEA聯閤CABG手術患者的臨床資料，其中男21例，女13例；年齡54～85歲，平均（70±6）歲。所有患者術前均行冠狀動脈和頸動脈造影明確診斷，其中冠狀動脈左主榦病變6例，3支血管病變17例，2支血管病變11例。先行CEA再行CABG者33例，1例先行CABG再行CEA。Off-Pump CABG 26例，On-Pump 8例。 CEA全部為單側，術中均使用頸動脈轉流管，併採用人工血管補片加寬頸動脈切口。結果無手術死亡病例，無圍術期心肌梗死、腦血管意外。1例于術後1箇月因下肢動脈硬化閉塞癥行右側股-腘動脈人工血管搭橋術。術後隨訪6～84箇月，無心腦血管事件髮生。結論同期行CEA聯閤CABG處理頸動脈與冠狀動脈狹窄併存疾病安全、有效，可有效預防圍術期心腦血管併髮癥的髮生，中期隨訪效果滿意。
목적평개동기행경동맥내막박탈술（CEA）연합관상동맥탑교술（CABG）치료경동맥여관상동맥협착병존질병적안전성화림상료효。방법총결2000년1월지2013년8월아과수치적34례병존경동맥여관상동맥협착병균실시료동기CEA연합CABG수술환자적림상자료，기중남21례，녀13례；년령54～85세，평균（70±6）세。소유환자술전균행관상동맥화경동맥조영명학진단，기중관상동맥좌주간병변6례，3지혈관병변17례，2지혈관병변11례。선행CEA재행CABG자33례，1례선행CABG재행CEA。Off-Pump CABG 26례，On-Pump 8례。 CEA전부위단측，술중균사용경동맥전류관，병채용인공혈관보편가관경동맥절구。결과무수술사망병례，무위술기심기경사、뇌혈관의외。1례우술후1개월인하지동맥경화폐새증행우측고-객동맥인공혈관탑교술。술후수방6～84개월，무심뇌혈관사건발생。결론동기행CEA연합CABG처리경동맥여관상동맥협착병존질병안전、유효，가유효예방위술기심뇌혈관병발증적발생，중기수방효과만의。
Objective To evaluate clinical safety and efficiency of simultaneous carotid endarterectomy ( CEA) and coronary artery bypass grafting ( CABG) on patients with combined carotid and coronary artery stenosis . Methods From January 2000 to August 2013,34 patients[21males,13 females,aged(70 ±6)years in average] underwent combined CEA and CABG in our department .Preoperative coronary and carotid artery angiography revealed that left main trunk stenosis occurred in 6 cases,triple-vessel disease in 17 cases,double-vessel disease in 11 cases.33 patients were given unilateral CEA firstly and then CABG .Only 1 case was given CABG firstly and then unilateral CEA .26 cases received Off-Pump CABG and 8 cases underwent CABG with cardiopulmonary bypass support .An intraluminal carotid shunt and patch repair were used in all CEA procedure .Results There were no operative mortality and perioperative cardio-cerebral vascular accidents in our study .1 case received right femo-popliteal artificial graft bypass for lower extremity atherosclerotic occlusive disease 1 month after the simultaneous CEA and CABG.No cardiovascular events were observed during the 6 to 84-month follow-up.Conclusions Simultaneous CEA and CABG is effective and safety for patients combined carotid and coronary artery severe stenosis .It can effectively prevent postoperative cardio-cerebral vascular complications with satisfactory mid-term result.
