【摘要】：目的:探討同期頸動(dòng)脈支架術(shù)(CAS)及冠狀動(dòng)脈旁路移植術(shù)(CABG)治療頸動(dòng)脈狹窄合并冠心病的安全性與療效。方法:回顧性分析中日友好醫(yī)院2007年1月 2014年12月收治的25例頸動(dòng)脈狹窄合并冠心病患者資料,其中11例同期行CAS和CABG(同期組),14例分期行CAS和CABG(分期組),比較兩組患者的主要臨床指標(biāo)。結(jié)果:兩組患者術(shù)前基本資料具有可比性。所有患者手術(shù)均獲成功,無圍手術(shù)期死亡患者。與分期組比較,同期組中位手術(shù)時(shí)間(250minvs.280min)、中位住院時(shí)間(19dvs.24d)明顯縮短(均P0.05),中位術(shù)中出血量(750m Lvs.600m L)、輸血量(1000m Lvs.1200m L)、ICU時(shí)間(23hvs.24h)、呼吸機(jī)時(shí)間(19hvs.16.5h)差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。同期組出現(xiàn)術(shù)后30d內(nèi)小卒中1例,一過性腦缺血發(fā)作(TIA)1例,圍手術(shù)期肺部感染1例,術(shù)后短暫低血壓3例;分期組出現(xiàn)TIA2例,術(shù)后短暫低血壓4例,再次開胸止血1例,圍手術(shù)期肺部感染1例,兩組均無心肌梗死及死亡病例。結(jié)論:同期和分期行CAS和CABG治療頸動(dòng)脈狹窄合并冠心病均安全有效,同期手術(shù)可以縮短手術(shù)和住院時(shí)間,應(yīng)根據(jù)患者的病變特點(diǎn)選擇合適的治療方法。
[Abstract]:Objective: to evaluate the safety and efficacy of simultaneous carotid stenting (CAS) and coronary artery bypass grafting (CABG) in the treatment of carotid artery stenosis with coronary heart disease. Methods: the data of 25 patients with carotid artery stenosis complicated with coronary heart disease in China-Japan Friendship Hospital from January 2007 to December 2014 were retrospectively analyzed. Among them, 11 cases were treated with CAS and CABG (simultaneous group) and 14 cases with CAS and CABG (staging group). The main clinical indexes of the two groups were compared. Results: the basic data of the two groups were comparable before operation. All patients were successfully operated without perioperative death. Compared with the staging group, the median operative time (250minvs.280min), median hospitalization time (19dvs.24d) and blood loss during operation (750m Lvs.600m L),) (1000m Lvs.1200m L),) were significantly shortened in the same group (P0.05). ICU time (23hvs.24h) and ventilator time (19hvs.16.5h) were not significantly different (P0.05). In the same group, there were 1 case of stroke, 1 case of transient ischemic attack of (TIA), 1 case of perioperative pulmonary infection and 3 cases of transient hypotension. TIA2 appeared in the staging group, hypotension occurred in 4 cases, rethoracotomy hemostasis occurred in 1 case and pulmonary infection in the perioperative period in 1 case. There were no myocardial infarction or death cases in both groups. Conclusion: CAS and CABG are safe and effective in the treatment of carotid artery stenosis complicated with coronary heart disease at the same time and CABG can shorten the operation and hospitalization time. The appropriate treatment should be selected according to the pathological characteristics of the patients.
【作者單位】： 中日友好醫(yī)院心臟血管外科;北京協(xié)和醫(yī)學(xué)院研究生院;
【基金】：中日友好醫(yī)院院級科研基金資助項(xiàng)目(2014-1-QN-1)
【分類號】：R654.2

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本文編號：2316633