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非体外循环冠状动脉旁路移植术与体外循环冠状动脉旁路移植术:对于慢性阻塞性肺疾病患者,哪种方法更好?

Off-pump coronary artery bypass grafting versus on-pump coronary artery bypass grafting: which is better in patients with chronic obstructive pulmonary disease?

作者信息

Zhu Ya-Bing, Xu Jian-Ping, Liu Zhi-Yong, Yang Dan-Ning, Li Xü-Dong, Li Hong-Yan

机构信息

Department of Thoracic and Cardiovascular Surgery, Affiliated Zhong-da Hospital, Southeast University, Nanjing 210009, China.

出版信息

J Zhejiang Univ Sci. 2004 Aug;5(8):1005-8. doi: 10.1007/BF02947615.

Abstract

To evaluate the clinic outcome of off-pump coronary bypass grafting (OPCABG) of patients with coronary heart disease and chronic obstructive pulmonary disease, we collected and analyzed 1998-2002 data on 28 patients with these two diseases who had received off-pump coronary bypass operation in our hospital, and compared with data on those who also had the same two diseases but received on-pump coronary artery bypass at same time. There were no operation-related death; one died of respiratory failure 14 days after operation while staying in hospital; there were more respiratory complications in the conventional coronary artery bypass grafting group (CCABG) than in the OPCABG group; and the PaO2/FiO2 in the CCABG group was higher than that in the OPCABG group during operation because of CPB, but lower than that in the OPCABG group 6-12 hours after operation. OPCABG seemed more suitable than CCABG for coronary artery disease patients with chronic obstructive pulmonary disease due to less damage to their oxygen-exchange capability and the fewer respiratory complications.

摘要

为评估冠心病合并慢性阻塞性肺疾病患者非体外循环冠状动脉搭桥术(OPCABG)的临床疗效,我们收集并分析了1998年至2002年期间在我院接受非体外循环冠状动脉搭桥手术的28例患有这两种疾病患者的数据,并与同期患有相同两种疾病但接受体外循环冠状动脉搭桥术患者的数据进行比较。无手术相关死亡;1例患者术后住院期间于术后14天死于呼吸衰竭;传统冠状动脉搭桥术组(CCABG)的呼吸并发症多于非体外循环冠状动脉搭桥术组;由于体外循环,CCABG组术中的动脉血氧分压/吸入氧浓度比值高于OPCABG组,但术后6至12小时低于OPCABG组。由于对氧交换能力的损害较小且呼吸并发症较少,非体外循环冠状动脉搭桥术似乎比传统冠状动脉搭桥术更适合患有慢性阻塞性肺疾病的冠心病患者。

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