CAJ | 학술논문

目的：针对南昌大学第三附属医院2003年7月～2013年12月的16例急性重症冠心病患者进行急诊冠状动脉旁路移植术（ECABG）治疗的临床体会。方法16例急性重症冠心病患者中16例患者均在术前常规放置IABP，均在体外循环下进行急诊冠状动脉旁路移植术治疗。结果急性心梗10例，其中伴心源性休克5例，PCI失败5例；顽固性心绞痛3例；陈旧性心梗合并室壁瘤2例；陈旧性心梗合并二尖瓣关闭不全1例。16例患者在急诊冠状动脉旁路移植术治疗早期死亡2例，术后低心排4例，肺部感染3例，切口愈合不良1例，14例患者均痊愈出院。结论在对急性重症冠心病患者采取急诊冠状动脉旁路移植术治疗时，要提高急诊冠状动脉旁路移植术治疗成功率，应充分重视急诊冠状动脉旁路移植术术前患者合并症处理、术中要强化患者心肌保护，并选择适合患者的血管移植材料及术后心功能维护，这样才能提高急诊冠状动脉旁路移植术治疗的临床效果。
목적：침대남창대학제삼부속의원2003년7월～2013년12월적16례급성중증관심병환자진행급진관상동맥방로이식술（ECABG）치료적림상체회。방법16례급성중증관심병환자중16례환자균재술전상규방치IABP，균재체외순배하진행급진관상동맥방로이식술치료。결과급성심경10례，기중반심원성휴극5례，PCI실패5례；완고성심교통3례；진구성심경합병실벽류2례；진구성심경합병이첨판관폐불전1례。16례환자재급진관상동맥방로이식술치료조기사망2례，술후저심배4례，폐부감염3례，절구유합불량1례，14례환자균전유출원。결론재대급성중증관심병환자채취급진관상동맥방로이식술치료시，요제고급진관상동맥방로이식술치료성공솔，응충분중시급진관상동맥방로이식술술전환자합병증처리、술중요강화환자심기보호，병선택괄합환자적혈관이식재료급술후심공능유호，저양재능제고급진관상동맥방로이식술치료적림상효과。
Objective 16 cases of severe acute coronary heart disease (CHD) patients form July 2003 to December 2013 in the hospital were emergency coronary artery bypass grafting (ECABG) treatment of clinical experience. Methods 16 cases of severe acute coronary heart disease in 16 patients were routinely placed in the preoperative IABP, were performed emergency coronary artery bypass surgery under cardiopulmonary bypass. Results 10 cases of acute myocardial infarction (ami), including 5 cases with cardiac shock, PCI failed in 5 cases;Intractable angina pectoris (3 cases);Chronic myocardial infarction merger aneurysm in 2 cases;Chronic myocardial infarction combined mitral insufifciency in 1 case. 16 patients in emergency coronary artery bypass grafting in early death in 2 cases, 4 cases were postoperative low cardiac, pulmonary infection (3 cases), poor healing of wound, 14 patients were recovered. Conclusion When taken to the emergency room with acute coronary heart disease patients with severe coronary artery bypass grafting treatment, to improve emergency coronary artery bypass grafting treatment success rates, should pay full attention before emergency coronary artery bypass graft surgery in patients with treatment complications, intraoperative to strengthen the patients with myocardial protection, and select the appropriate patient's vascular graft materials and maintenance of cardiac function, so as to improve the clinical effect of emergency coronary artery bypass grafting treatment.