本文選題：雜交技術(shù)　切入點(diǎn)：微創(chuàng)冠狀動(dòng)脈搭橋　出處：《中國(guó)老年學(xué)雜志》2017年03期 　論文類型：期刊論文

【摘要】：目的 探討分期非體外循環(huán)微創(chuàng)冠狀動(dòng)脈搭橋(MIDCAB)聯(lián)合經(jīng)皮冠狀動(dòng)脈介入(PCI)雜交技術(shù)治療老年多支復(fù)雜冠心病患者的早期療效及預(yù)后。方法 選取31例年齡60~83歲多支復(fù)雜冠心病患者,用血管內(nèi)超聲(IVUS)和血流儲(chǔ)備分?jǐn)?shù)(FFR)對(duì)病變進(jìn)行評(píng)估,采取分期非體外循環(huán)對(duì)前降支(LAD)和左內(nèi)乳動(dòng)脈(LIMA)行微創(chuàng)冠狀動(dòng)脈搭橋(MIDCAB),對(duì)非LAD血管右冠狀動(dòng)脈(RCA)和回旋支(LCX)植入支架。觀察早期院內(nèi)指標(biāo)及隨訪1~3年主要心血管不良事件情況。結(jié)果 復(fù)雜病變(B2+C型)占83.2%,人均植入支架1.6個(gè),人均再血管化2.6支,合理使用抗凝抗血小板藥物,胸腔引流量(312±195)ml,輸血占29%,術(shù)后脫機(jī)時(shí)間(8.0±3.2)h,ICU時(shí)間(24±8)h,無(wú)PCI及MIDCAB死亡病例,無(wú)二次開胸及腦卒中。隨訪1~3年再血管化PCI 2例,均非LAD病變,再發(fā)心絞痛4例,無(wú)心源性死亡、急性心肌梗死及急性心衰病例。結(jié)論 合理選擇病例,科學(xué)評(píng)估病變,分期雜交技術(shù)可用于多支復(fù)雜病變的老年冠心病患者,早期及預(yù)后安全有效。
[Abstract]:Objective to investigate the early efficacy and prognosis of minimally invasive coronary artery bypass graft (MIDCAB) combined with percutaneous coronary intervention (PCI) hybridization in the treatment of elderly patients with complex coronary artery disease. Patients with complex coronary artery disease, The lesions were evaluated by intravascular ultrasound (IVUS) and flow reserve fraction (FFR). The anterior descending artery (lad) and left internal mammary artery (LIMA) were treated by staging off-pump bypass (LAD) and left internal mammary artery (LIMA). Stent implantation was performed on the right coronary artery (RCA) and circumflex branch (LCX) of non LAD vessels. The early hospital parameters and the follow-up of major cardiovascular diseases were observed and followed up for 1 ~ 3 years. Results the incidence of complex lesions was 83.2%, and the average number of stents implanted was 1.6. There were 2.6 revascularization per capita, rational use of anticoagulant and antiplatelet drugs, pleural drainage volume (312 鹵195ml), blood transfusion (29.9%), postoperative weaning time (8.0 鹵3.2hICU), 24 鹵8h. no PCI and MIDCAB death, no rethoracotomy and stroke. 2 cases were followed up for 1 ~ 3 years and then re-vascularized PCI. There were no cardiac death, acute myocardial infarction and acute heart failure in 4 patients with non-#en0# disease, 4 patients with recurrent angina pectoris. Conclusion reasonable selection of cases, scientific evaluation of pathological changes and staging hybridization technique can be used in elderly patients with multiple complex coronary artery disease. The early stage and prognosis are safe and effective.
【作者單位】： 河南省胸科醫(yī)院心內(nèi)科;河南省胸科醫(yī)院心外科;
【分類號(hào)】：R541.4

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