乳内动脉skeleton取材法在冠状动脉旁路移植术中的应用

被引:4
作者
熊利华 [1 ]
华平 [1 ]
李佳 [1 ]
张惠忠 [1 ]
魏益平 [1 ]
王铭辉 [1 ]
张华 [1 ]
Olivier BICAL [2 ]
机构
[1] 中山大学附属第二医院心胸外科
[2] 法国巴黎St-Joseph医院心脏外科
关键词
乳内动脉; Skeleton取材法; 冠状动脉旁路移植术;
D O I
暂无
中图分类号
R654.2 [心脏];
学科分类号
100408 [卫生政策与卫生管理学];
摘要
目的评价乳内动脉skeleton取材法在冠状动脉旁路移植术(CABG)中的应用及其效果。方法277例接受CABG的患者(其中合并糖尿病33例)在术中分离乳内动脉的过程中,仅使用剪刀和钛夹来分离乳内动脉,即不附带任何周围组织的skeleton取材法游离一侧或两侧乳内动脉,其中21例糖尿病患者取用双侧乳内动脉;并观察患者术中、术后的临床结果。采用非体外循环CABG5例,体外循环CABG272例。结果体外循环时间60~217min,平均90.1min;主动脉阻断时间30~160min,平均53.3min。手术死亡率2.2%(6/277)。手术中见乳内动脉桥质量良好,动脉桥血流量满意;术后移植血管通畅,心绞痛症状消失。取用双侧乳内动脉和糖尿病患者亦未出现更高的胸骨感染率。手术后冠状动脉造影显示乳内动脉血管桥通畅。结论乳内动脉skeleton取材法有良好的血管桥通畅率,对患者胸骨创伤较小,对糖尿病患者取用双侧乳内动脉不再是禁忌证。
引用
收藏
页码:252 / 255
页数:4
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