非体外循环下冠状动脉旁路移植术并室壁瘤线样缝合13例治疗体会

doi:10.3969/j.issn.10073205.2017.04.011

河北医科大学学报

非体外循环下冠状动脉旁路移植术并室壁瘤线样缝合13例治疗体会

河北医科大学第二医院心脏外科，河北石家庄 050000

出版日期:2017-04-25 发布日期:2017-04-25
作者简介:安景辉（1980-），男，河北省石家庄人，河北医科大学第二医院主治医师，医学硕士，从事心脏外科疾病诊治研究。
基金资助:
河北省医学科学研究重点课题（20160089）

Experience of offpump coronary artery bypass grafting accompany ventricular aneurysm treatment line like suture in 13 cases

Department of Cardiac Suegery, the Second Hospital of Hebei Medical University， Shijiazhuang 050000， China

Online:2017-04-25 Published:2017-04-25

摘要/Abstract

摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗探讨非体外循环下行冠心病室壁瘤的外科治疗临床经验和手术效果。
〖HTH〗方法〖HTSS〗〖KG*2〗13例冠心病陈旧性心肌梗死患者术前冠状动脉造影显示冠状动脉均有病变，术前行心脏彩色超声提示左心室心尖部室壁瘤形成（无附壁血栓形成），均在非体外循环心脏跳动下线样缝合，同期行冠状动脉旁路移植术。比较其术前及术后心功能、射血分数、左心室舒张末期内径等指标的变化。
〖HTH〗结果〖HTSS〗〖KG*2〗手术无死亡，随访3~15个月，平均9个月，无死亡病例。患者术后较术前左心室射血分数升高，左心室舒张末期内径减少，纽约心脏协会（New York Heart Association，NYHA）Ⅱ级例数增多，差异均有统计学意义（P＜005）。
〖HTH〗结论〖HTSS〗〖KG*2〗非体外循环下室壁瘤线样缝合术是治疗部分心肌梗死后心尖部室壁瘤的有效方法，可以取得较满意的手术效果。手术安全、可靠，可明显改善术后心功能，减少术后血栓形成及心脏破裂等相关并发症发生。

关键词: 冠状动脉旁路移植术, 非体外循环, 室壁瘤, 线样缝合

Abstract: ［Abstract］ Objective〖HTSS〗〓To explore clinical experience of offpump surgical treatment on coronary aneurysm.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 13 cases of coronary heart disease patients with old myocardial infarction were included in this study. Their preoperative echocardiography showed the formation of left ventricular apex aneurysm without thrombosis. All the aneurysms were sutured associated with offpump coronary artery bypass grafting surgery. The cardiac function, ejection fraction, left ventricular end diastolic diameter postoperatively were compared with those preoperatively.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓No death was occurred in operation. The followup time ranged from 3 to 15 months, averaged at 9 months. The postoperative left ventricular ejection fraction was increased and left ventricular end diastolic diameter was decreased. The number of New York Heart Association(NYHA) Ⅱ level cases was increased. The difference was statistically significant.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Offpump coronary artery bypass grafting with left ventricular aneurysm suture is an effective method for some kind of infarction ventricular aneurysm, which can get satisfactory results. Operation is safe and reliable, which can significantly improve postoperative cardiac function, reduce postoperative thrombosis and cardiac rupture and other complications.

Key words: coronary artery bypass, offpump, aneurysm of ventricle, stitch suture

安景辉，石凤梧，马千里，刘〓苏*. 非体外循环下冠状动脉旁路移植术并室壁瘤线样缝合13例治疗体会[J]. 河北医科大学学报, doi: 10.3969/j.issn.10073205.2017.04.011.

AN Jinghui, SHI Fengwu, MA Qianli, LIU Su*. Experience of offpump coronary artery bypass grafting accompany ventricular aneurysm treatment line like suture in 13 cases[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.10073205.2017.04.011.

[1]	刘钰，顾建军，张文立，步纪强，孙涌泉，陈子英*. No-Touch技术获取静脉移植血管术后下肢并发症的临床观察[J]. 河北医科大学学报, 2020, 41(5): 528-531.
[2]	安景辉，刘苏，陈子英，马千里，闫芳，石凤梧*. No-touch获取大隐静脉桥血管在CABG中的应用及近中期桥血管通畅率观察[J]. 河北医科大学学报, 2020, 41(1): 24-28.
[3]	宋书田，王玉通，周岊梧，白传明，杨〓明. 重组人脑利钠肽对非体外循环冠状动脉搭桥患者术后BNP、cTnI、LVEF的影响[J]. 河北医科大学学报, 2018, 39(2): 150-154.
[4]	李强1,刘艳超1,刘超2,孟自力1, 王维3*,刘永辉1 . 心肌梗死患者自体外周血干细胞动员、采集效率与移植安全性的研究[J]. 河北医科大学学报, 2016, 37(5): 531-536.
[5]	孙文波,张立民,吴春玲,李睿. 不停跳冠状动脉搭桥术后不同呼气末正压水平下应用右美托咪定镇静的比较研究[J]. 河北医科大学学报, 2016, 37(2): 183-186.
[6]	张青娟;张岗;郭艳慧;秦建锐;刘春娟;周丽. 非体外循环冠状动脉搭桥患者围手术期临床护理路径的应用[J]. , 2014, 35(6): 644-644.

非体外循环下冠状动脉旁路移植术并室壁瘤线样缝合13例治疗体会

Experience of offpump coronary artery bypass grafting accompany ventricular aneurysm treatment line like suture in 13 cases

HTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 6

编辑推荐

Metrics

本文评价