CAJ | 학술논문

目的：探讨老年（70岁以上）冠心病患者冠状动脉旁路移植术（CABG）的术式选择、临床疗效和围术期处理。方法选择2005年1月～2013年12月间58例≥70岁接受冠状动脉旁路移植术的患者，分为非体外循环冠状动脉旁路移植术组（OPCAB）36例和体外循环下冠状动脉旁路移植术组（ONCAB）22例，比较两组临床疗效、术后死亡率及并发症的发生情况。结果 OPCAB组和ONCAB组的手术时间为（178.47±28.72）min和（257.35±30.53）min、呼吸机辅助时间（10.10±7.32）h和(16.24±7.25)h、术后住院时间（8.3±2.5）d和（12.6±3.5）d，差异有统计学意义（P＜0.05），但两组在术后死亡、脑卒中等并发症方面无统计学意义（P＞0.05）。结论 CABG术式的选择不影响高龄冠心病患者的预后，手术方案的个性化制定和围术期的密切监护，是确保手术疗效的关键。
목적：탐토노년（70세이상）관심병환자관상동맥방로이식술（CABG）적술식선택、림상료효화위술기처리。방법선택2005년1월～2013년12월간58례≥70세접수관상동맥방로이식술적환자，분위비체외순배관상동맥방로이식술조（OPCAB）36례화체외순배하관상동맥방로이식술조（ONCAB）22례，비교량조림상료효、술후사망솔급병발증적발생정황。결과 OPCAB조화ONCAB조적수술시간위（178.47±28.72）min화（257.35±30.53）min、호흡궤보조시간（10.10±7.32）h화(16.24±7.25)h、술후주원시간（8.3±2.5）d화（12.6±3.5）d，차이유통계학의의（P＜0.05），단량조재술후사망、뇌졸중등병발증방면무통계학의의（P＞0.05）。결론 CABG술식적선택불영향고령관심병환자적예후，수술방안적개성화제정화위술기적밀절감호，시학보수술료효적관건。
Objective To explore the selection of operation,clinical efficacy and perioperative treatment of coronary artery bypass graft for elderly patients (above 70 years old). Methods 58 patients,who were above70 years and given coronary artery bypass grafting from 2005 January to 2013 December,were selected and divided into the off-pump coronary artery bypass grafting group (OPCAB group) in 36 cases and on-pump coronary artery bypass grafting group (ONCAB) in 22 cases.The clinical curative effect,the postoperative mortality and complications of two groups were compared. Results The operation time(178.47+28.72)min,the time of mechanical ventilation (10.10±7.32) hours,hospitalization time and postoperative (8.3±2.5) days of OPCAB group were significantly shorter then those of the ONCAB group (257.35±30.53) minutes,(16.24±7.25)hours,and(12.6±3.5)days, (P < 0.05),but the incidence of the postoperative death,stroke and other complications of two groups had no statistical significance (P > 0.05). Conclusion The choice of CABG operative method did not affect the prognosis of elderly patients with coronary heart disease.The operation scheme formulation of operation scheme and close perioperative monitoring are the keys to ensure the efficacy of operation.