80岁以上高龄患者冠状动脉旁路移植术的围术期处理

被引：7

作者：

黄日太

薛松

刘沙

胡振雷

王颍骅

姚陈一

朱洪生

机构：

[1] 上海交通大学医学院附属仁济医院心胸外科

来源：

中国胸心血管外科临床杂志 | 2007年 / 05期

关键词：

高龄; 冠状动脉旁路移植术; 围术期处理;

D O I：

暂无

中图分类号：

R654.2 [心脏];

学科分类号：

1002 ; 100210 ;

摘要：

目的探讨80岁以上高龄患者行冠状动脉旁路移植术(CABG)的围术期处理经验。方法自2001年6月至2007年3月,我院共为56例80岁(82.98±5.97岁)以上高龄患者行单纯CABG,其中体外循环CABG9例,非体外循环CABG(OPCAB)47例。每例移植血管1～5支(2.99±0.47支)。结果围术期死亡4例(7.14%),死于呼吸衰竭2例、低心排血量综合征1例、急性肾功能衰竭1例。术后发生低心排血量综合征5例、呼吸系统并发症6例(3例行气管切开)、急性肾功能损伤4例(2例行持续性肾脏替代治疗)。术后发生心房颤动39例。术中和术后应用主动脉内球囊反搏3例,呼吸机辅助时间12.0±9.8h,住ICU时间3.91±1.98d,术后住院时间12.35±4.46d。48例患者随访1～59个月,随访期间死亡10例,生存的患者心绞痛症状均缓解或消失。结论80岁以上高龄患者行CABG仍有较高的死亡率,应加强围术期处理,以进一步降低死亡率和并发症的发生率。

引用

页码：326 / 329

页数：4

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