中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
24期
1906-1909
,共4页
樊雪强%刘鹏%叶志东%陈洁%马博%朱爽%甄雅楠%郑夏%王非
樊雪彊%劉鵬%葉誌東%陳潔%馬博%硃爽%甄雅楠%鄭夏%王非
번설강%류붕%협지동%진길%마박%주상%견아남%정하%왕비
同期血运重建%颈动脉与冠状动脉并存重度狭窄%颈动脉内膜切除术%冠状动脉旁路移植术
同期血運重建%頸動脈與冠狀動脈併存重度狹窄%頸動脈內膜切除術%冠狀動脈徬路移植術
동기혈운중건%경동맥여관상동맥병존중도협착%경동맥내막절제술%관상동맥방로이식술
Synchronous revascularization%Concomitant carotid and coronary severe stenosis%Carotid endarterectomy%Coronary artery bypass grafting
目的 分析颈动脉及冠状动脉并存重度狭窄患者接受同期血运重建的临床疗效.方法 回顾性分析2012年5月至2014年4月中日友好医院12例颈动脉合并冠状动脉重度狭窄患者资料,其中男10例,女2例,平均年龄(64.5±5.9)岁.统计患者的基本特征、手术方式、围手术期并发症及术后30 d健康调查情况.依据颈动脉处理方式将患者分为手术组和支架组,应用查尔森合并症指数和SF-36量表比较2组患者的基础病情和术后30 d时健康情况,以及住院时间、住院费用、呼吸机时间、术后引流及输血量等情况.结果 12例患者共接受了30条冠状动脉血管重建,8例次颈动脉内膜切除术(CEA),5例次颈动脉支架植入术(CAS).1例患者同时接受了冠状动脉旁路移植术及右侧CEA和左侧CAS.术后30 d内出现小卒中2例(16.7%),一过性脑缺血发作(TIA)1例(8.3%),胸部切口感染1例.术后11例(91.7%)患者接受成分输血.无心肌梗死及死亡病例.平均住院时间(36.5±25.3)d,术后呼吸机应用时间为(37.5±31.2)h,术后心包及纵隔引流量为(347.92±105.69)ml,术后输注浓缩红细胞4.3U.颈动脉手术组和支架组患者查尔森指数分别为(5.57±1.51)和(4.25±1.50),差异无统计学意义(f=1.40,P>0.05);SF-36量表结果分别为(3.63±1.76)和(5.44±1.05),差异无统计学意义(t=-1.85,P>0.05).2组患者在住院时间、呼吸机应用时间、输血量、术后引流量及住院费用方面差异均无统计学意义(均P>0.05).结论 同期血运重建治疗颈动脉及冠状动脉并存重度狭窄患者的近期疗效满意,颈动脉手术组和支架组的临床效果相似.
目的 分析頸動脈及冠狀動脈併存重度狹窄患者接受同期血運重建的臨床療效.方法 迴顧性分析2012年5月至2014年4月中日友好醫院12例頸動脈閤併冠狀動脈重度狹窄患者資料,其中男10例,女2例,平均年齡(64.5±5.9)歲.統計患者的基本特徵、手術方式、圍手術期併髮癥及術後30 d健康調查情況.依據頸動脈處理方式將患者分為手術組和支架組,應用查爾森閤併癥指數和SF-36量錶比較2組患者的基礎病情和術後30 d時健康情況,以及住院時間、住院費用、呼吸機時間、術後引流及輸血量等情況.結果 12例患者共接受瞭30條冠狀動脈血管重建,8例次頸動脈內膜切除術(CEA),5例次頸動脈支架植入術(CAS).1例患者同時接受瞭冠狀動脈徬路移植術及右側CEA和左側CAS.術後30 d內齣現小卒中2例(16.7%),一過性腦缺血髮作(TIA)1例(8.3%),胸部切口感染1例.術後11例(91.7%)患者接受成分輸血.無心肌梗死及死亡病例.平均住院時間(36.5±25.3)d,術後呼吸機應用時間為(37.5±31.2)h,術後心包及縱隔引流量為(347.92±105.69)ml,術後輸註濃縮紅細胞4.3U.頸動脈手術組和支架組患者查爾森指數分彆為(5.57±1.51)和(4.25±1.50),差異無統計學意義(f=1.40,P>0.05);SF-36量錶結果分彆為(3.63±1.76)和(5.44±1.05),差異無統計學意義(t=-1.85,P>0.05).2組患者在住院時間、呼吸機應用時間、輸血量、術後引流量及住院費用方麵差異均無統計學意義(均P>0.05).結論 同期血運重建治療頸動脈及冠狀動脈併存重度狹窄患者的近期療效滿意,頸動脈手術組和支架組的臨床效果相似.
목적 분석경동맥급관상동맥병존중도협착환자접수동기혈운중건적림상료효.방법 회고성분석2012년5월지2014년4월중일우호의원12례경동맥합병관상동맥중도협착환자자료,기중남10례,녀2례,평균년령(64.5±5.9)세.통계환자적기본특정、수술방식、위수술기병발증급술후30 d건강조사정황.의거경동맥처리방식장환자분위수술조화지가조,응용사이삼합병증지수화SF-36량표비교2조환자적기출병정화술후30 d시건강정황,이급주원시간、주원비용、호흡궤시간、술후인류급수혈량등정황.결과 12례환자공접수료30조관상동맥혈관중건,8례차경동맥내막절제술(CEA),5례차경동맥지가식입술(CAS).1례환자동시접수료관상동맥방로이식술급우측CEA화좌측CAS.술후30 d내출현소졸중2례(16.7%),일과성뇌결혈발작(TIA)1례(8.3%),흉부절구감염1례.술후11례(91.7%)환자접수성분수혈.무심기경사급사망병례.평균주원시간(36.5±25.3)d,술후호흡궤응용시간위(37.5±31.2)h,술후심포급종격인류량위(347.92±105.69)ml,술후수주농축홍세포4.3U.경동맥수술조화지가조환자사이삼지수분별위(5.57±1.51)화(4.25±1.50),차이무통계학의의(f=1.40,P>0.05);SF-36량표결과분별위(3.63±1.76)화(5.44±1.05),차이무통계학의의(t=-1.85,P>0.05).2조환자재주원시간、호흡궤응용시간、수혈량、술후인류량급주원비용방면차이균무통계학의의(균P>0.05).결론 동기혈운중건치료경동맥급관상동맥병존중도협착환자적근기료효만의,경동맥수술조화지가조적림상효과상사.
Objective To analyze the outcomes of synchronous revascularization for patients concomitant carotid and coronary artery severe stenosis.Methods From May 2012 to April 2014,12 cases who received one-stage operation was retrospective analyzed,including the characteristics,methods of treatment,perioperative complications and health survey 30 days post procedure.Two subgroups were divided according to the different treatment methods on carotid artery,WIC and SF-36 scale were applied to compare the basic condition and recovery situation between 2 groups,the hospital stay time,costs,ventilation time,drainage and blood transfusion volmne were also be compared.Results Totally 30 coronary vcsscls 8 carotid endarterectomy (CEA) and 5 carotid artery stenting (CAS) were performed on 12 patients.One patient also received coronary artery bypass grafting and bilateral carotid artery revascularization (CEA on right and CAS on left).Two (16.67%) minor stroke,1 (8.33%) TIA,1 wound infection occurred within 30 days post procedure,and 11 (91.67%) received blood component transfusion.No myocardial infarction and death occured.The average hospital stay time were (36.5 ± 25.3) days,ventilator application (37.5 ± 31.2) hours,postoperative drainage volume from pericardial and mediastinal was (347.92 ± 105.69) ml,infusion of concentrated red cell was 4.3 U.WIC was (5.57 ± 1.51) in CEA and (4.25 ± 1.50) in CAS subgroup,there was no significantly statistical difference (t =1.40,P >0.05).the results of SF-36 was (3.63 ± 1.76) and (5.44 ± 1.05) in CEA and CAS subgroup,there was no significantly statistical difference (t =-1.85,P > 0.05).In hospital stay time,ventilator application time,transfusion and drainage volume,hospitalization costs were also no significant statistical difference between two groups.Conclusions The early outcome of synchronous revascularization on concomitant carotid and coronary severe stenosis disease is satisfactory.The clinical results are similar in the CEA and CAS subgroup.