非体外循环下冠状动脉旁路移植术60例临床分析
非体外循环,,非体外循环；,冠状动脉旁路移植术；,心脏手术,1资料和方法,2结果,3讨论,参考文献:
摘要： 目的： 探讨非体外循环下冠状动脉旁路移植术的治疗经验。方法： 对60例冠状动脉硬化性心脏病患者行非体外循环下冠状动脉旁路移植术(OPCAB)，均采用OCTOPUSⅡ型负压心脏稳定器辅助控制局部心肌运动，阻断冠状动脉下进行血管吻合。结果： 共行移植物与冠状动脉吻合192支(3.2支/例)。手术后死于呼吸功能衰竭1例，出现围术期心肌梗死1例。25例患者未输入库血。结论： OPCAB有明显的优越性，若无同期矫治心内病理改变，大多数病人可应用OPCAB。术中应维持稳定的血液动力学指标。冠状动脉吻合程序应先行前降支系统，狭窄最严重的血管宜先吻合。体外循环应提前准备。关键词： 非体外循环； 冠状动脉旁路移植术； 心脏手术
The clinical experience of offpump coronary artery bypass surgery
HUO Qiang, QIAO Jun, Mulati, et al
(Department of Cardiovascular Surgery, First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054, China)
Abjective: Objective: To evaluate the clinical experience of offpump coronary artery bypass surgery (OPCAB). Methods: From 2001 November to 2003 October, 60 cases of OPCAB were included in this study. All operations were undergone with the assistance of Octopus Ⅱ heart stabilizer and temporary occlusion of target coronary arteries. Results: The total anastomases were 192, with a mean of 3.2 per case. One patient died of serious respiratory function failure, One patient had acute myocardial infarct postoperatively. 25 patients don't accept blood transfusion. Conclusion: OPCAB can be safely used in many pure coronary artery bypass patients without any harmful effects of cardiopulmonary bypass. A stable hemodynamics must be maintained during OPCAB. The distal anastomosis should start from the left anterior descending system; the most stenosed target coronary artery should be bypassed first. Heartlung machine and perfusioninst stand by are necessary for OPCAB. ......
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