中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2015年
3期
171-174
,共4页
彭建辉%韩劲松%王辉山%吴海波
彭建輝%韓勁鬆%王輝山%吳海波
팽건휘%한경송%왕휘산%오해파
冠状动脉旁路移植,非体外循环%内窥镜%大隐静脉
冠狀動脈徬路移植,非體外循環%內窺鏡%大隱靜脈
관상동맥방로이식,비체외순배%내규경%대은정맥
Coronary artery bypass grafting,off-pumping%Endoscopy%Great saphenous vein
目的 评价内窥镜采集大隐静脉(EVH)在70岁以上冠状动脉旁路移植(CABG)患者中的应用,比较近、中期疗效.方法 回顾性分析沈阳军区总医院2011年6月至2013年1月期间所有行CABG的患者资料,入选患者按大隐静脉采集方法分为2组,包括EVH组和全程开放切口采集大隐静脉(OVH)组,每组各200例;每组患者再按年龄分为A组(年龄≥70岁)和B组(年龄＜70岁).比较各组术中各指标水平、术后疼痛程度;应用组织学方法评价各组获取大隐静脉质量.出院后常规随访.结果 与OVH组比较,EVH组切口长度小,术后疼痛评分低,术后并发症和术后住院时间少,差异均有统计学意义(P＜0.05);两组采集的大隐静脉质量、总手术时间和总住院费用差异无统计学意义(P＞0.05).EVH组中,A组的疼痛评分、下肢麻木及水肿等术后并发症明显低于B组(P＜0.05);皮下血肿发生比例差异无统计学意义(P＞0.05);随访期间A、B组移植血管通畅率差异无统计学意义(P＞0.05).OVH组中,A组的疼痛评分明显低于B组(P＜0.05),其余各指标差异无统计学意义(P＞0.05).结论 CABG术中应用EVH近、中期治疗效果满意,尤其适用于70岁以上患者.
目的 評價內窺鏡採集大隱靜脈(EVH)在70歲以上冠狀動脈徬路移植(CABG)患者中的應用,比較近、中期療效.方法 迴顧性分析瀋暘軍區總醫院2011年6月至2013年1月期間所有行CABG的患者資料,入選患者按大隱靜脈採集方法分為2組,包括EVH組和全程開放切口採集大隱靜脈(OVH)組,每組各200例;每組患者再按年齡分為A組(年齡≥70歲)和B組(年齡＜70歲).比較各組術中各指標水平、術後疼痛程度;應用組織學方法評價各組穫取大隱靜脈質量.齣院後常規隨訪.結果 與OVH組比較,EVH組切口長度小,術後疼痛評分低,術後併髮癥和術後住院時間少,差異均有統計學意義(P＜0.05);兩組採集的大隱靜脈質量、總手術時間和總住院費用差異無統計學意義(P＞0.05).EVH組中,A組的疼痛評分、下肢痳木及水腫等術後併髮癥明顯低于B組(P＜0.05);皮下血腫髮生比例差異無統計學意義(P＞0.05);隨訪期間A、B組移植血管通暢率差異無統計學意義(P＞0.05).OVH組中,A組的疼痛評分明顯低于B組(P＜0.05),其餘各指標差異無統計學意義(P＞0.05).結論 CABG術中應用EVH近、中期治療效果滿意,尤其適用于70歲以上患者.
목적 평개내규경채집대은정맥(EVH)재70세이상관상동맥방로이식(CABG)환자중적응용,비교근、중기료효.방법 회고성분석침양군구총의원2011년6월지2013년1월기간소유행CABG적환자자료,입선환자안대은정맥채집방법분위2조,포괄EVH조화전정개방절구채집대은정맥(OVH)조,매조각200례;매조환자재안년령분위A조(년령≥70세)화B조(년령＜70세).비교각조술중각지표수평、술후동통정도;응용조직학방법평개각조획취대은정맥질량.출원후상규수방.결과 여OVH조비교,EVH조절구장도소,술후동통평분저,술후병발증화술후주원시간소,차이균유통계학의의(P＜0.05);량조채집적대은정맥질량、총수술시간화총주원비용차이무통계학의의(P＞0.05).EVH조중,A조적동통평분、하지마목급수종등술후병발증명현저우B조(P＜0.05);피하혈종발생비례차이무통계학의의(P＞0.05);수방기간A、B조이식혈관통창솔차이무통계학의의(P＞0.05).OVH조중,A조적동통평분명현저우B조(P＜0.05),기여각지표차이무통계학의의(P＞0.05).결론 CABG술중응용EVH근、중기치료효과만의,우기괄용우70세이상환자.
Objective To evaluate the early and mid-term efficacy of endoscopic vein harvesting(EVH) undergoing coronary artery bypass grafting(CABG) in patients over 70 years old.Methods Patients' data of CABG were analyzed retrospectively in General Hospital of Shenyang Military Region from June 2011 to January 2013.400 patients were enrolled in the study according to the inclusion criteria.All patients were divided into two groups by the method of harvesting great saphenous vein (GSV):EVH group (n =200) and open vein harvesting(OVH) group(n =200).Each group was divided into two subgroups:group A(age≥70 years old) and group B (age ＜ 70 years old).The number of the group A was 85 in the EVH group and 79 in the OVH group.The number of the group B was 115 in the EVH group and 121 in the OVH group.The intraoperative findings,the quality of GSV and postoperative pain were evaluated,patients were followed up regularly after discharge.Results The postoperative complications occurred in the EVH group such as numbness and edema of lower limb in group A reduced greatly compared with group B(P ＜ 0.05).However,in the OVH group,there were no great difference in group A and group B(P ＞ 0.05) besides the postoperative pain (P ＜ 0.05).Conclusion The early and mid-term efficacy of EVH undergoing CABG is satisfied,especially in the patients over 70 years old.
