CAJ | 학술논문

目的：观察80岁以上患者行冠状动脉旁路移植术（CABG）的临床效果。方法选择2001年10月至2013年10月，在北京军区总医院心血管外科行CABG手术年龄＞80岁的高龄冠心病患者60例，其中男性53例，女性7例，平均年龄（82.65±2.27）岁。急诊手术5例。体外循环下搭桥（on-pump）6例，非体外循环下搭桥（off-pump）54例。记录患者冠状动脉搭桥数量，围手术期呼吸机辅助呼吸时间、住院时间、重要脏器并发症发生率以及近期心肌缺血事件发生率。结果纳入患者平均搭桥（3.13±0.24）支，术后呼吸机辅助呼吸（10.11±4.37）h，平均住院时间（11.36±4.51）d。围手术期死亡率为5%。并发症发生率依次为胸腔积液（48.3%）、低氧及高碳酸血症（30.0%）、心房颤动（26.7%）、肾功能不全（23.3%）、低心排综合征（5.0%）等。患者出院后随访3个月，均无心肌缺血事件发生。结论做好充分的术前准备、评估及围手术期管理，80岁以上高龄患者的CABG手术依然可以取得良好效果。
목적：관찰80세이상환자행관상동맥방로이식술（CABG）적림상효과。방법선택2001년10월지2013년10월，재북경군구총의원심혈관외과행CABG수술년령＞80세적고령관심병환자60례，기중남성53례，녀성7례，평균년령（82.65±2.27）세。급진수술5례。체외순배하탑교（on-pump）6례，비체외순배하탑교（off-pump）54례。기록환자관상동맥탑교수량，위수술기호흡궤보조호흡시간、주원시간、중요장기병발증발생솔이급근기심기결혈사건발생솔。결과납입환자평균탑교（3.13±0.24）지，술후호흡궤보조호흡（10.11±4.37）h，평균주원시간（11.36±4.51）d。위수술기사망솔위5%。병발증발생솔의차위흉강적액（48.3%）、저양급고탄산혈증（30.0%）、심방전동（26.7%）、신공능불전（23.3%）、저심배종합정（5.0%）등。환자출원후수방3개월，균무심기결혈사건발생。결론주호충분적술전준비、평고급위수술기관리，80세이상고령환자적CABG수술의연가이취득량호효과。
Objective To observe the clinical efficacy of coronary artery bypass grafting (CABG) in aged patients over 80 with coronary heart disease (CHD).Methods The patients (n=60, male 53 and female 7, average age=82.65±2.27) with CABG were chosen from Oct. 2001 to Oct. 2013. Among them, there were 5 with emergency CABG, 6 with on-pump CABG, and 54 with off-pump CABG. The number of coronary bypass, respirator supporting time during perioperative period, hospitalization time, incidence of vital organs complications and short-term incidences of myocardial ischemia events were recorded.Results The average number of bypass was (3.13± 0.24), respirator supporting time after CABG was (10.11±4.37) h, average hospitalization time was (11.36±4.51) d. The perioperative mortality was 5%, and incidences of complications were, in a descending order, pleural effusion (48.3%), hyoxemia and hypercapnia (30.0%), atrial fibrillation (26.7%), renal insufficiency (23.3%) and low cardiac output syndrome (5.0%). All patients were followed up for 3 m after discharged from hospital and there were no myocardial ischemia events found.Conclusion With sufficient preoperative preparation, review and management, CABG will get good results in aged patients over 80.