Nogueira Celia R S R, Hueb Whady, Takiuti Myrthes E, Girardi Priscyla B M A, Nakano Teryo, Fernandes Fábio, Paulitsch Felipe da S, Góis Aécio F T, Lopes Neuza H M, Stolf Noedir A
Instituto do Coração do Hospital do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
Arq Bras Cardiol. 2008 Oct;91(4):217-22, 238-44. doi: 10.1590/s0066-782x2008001600006.
Coronary artery bypass grafting techniques without using cardiopulmonary bypass (off-pump CABG) result in less systemic damage, less clinical complications, less time spent in the intensive care unit, and shorter hospital stays, thereby raising the perspective of improved quality of life (QOL) for patients.
To assess quality of life in patients who underwent on-pump and off-pump CABG.
The Short-Form Health Survey (SF-36) Questionnaire was administered to patients with stable multivessel coronary artery disease (CAD) and preserved ventricular function before and at six and 12 months after surgery.
Between January 2002 and December 2006, a total of 202 patients were randomized to either on-pump or off-pump CABG. Demographic, clinical, laboratory, and angiographic characteristics were similar in both groups. One hundred and five patients underwent off-pump CABG and 97 underwent on-pump CABG. In the postoperative course, 22 patients had myocardial infarction, 29 reported angina, one was reoperated, and three experienced stroke. No patient died. Quality of life, as measured by the SF-36 questionnaire, was shown to be similar in both groups regarding physical and mental components. However, male patients showed a significant improvement in physical functioning and role limitations due to physical problems. Also, a large number of patients in both groups returned to work.
Progressive enhancement in quality of life and early return to work were observed for all patients, regardless of the surgical technique used. Save for a greater improvement in physical functioning and role limitations due to physical problems experienced by male patients, no statistically significant differences were found in the other domains between groups.
不使用体外循环的冠状动脉旁路移植术（非体外循环冠状动脉搭桥术）造成的全身损害更小、临床并发症更少、在重症监护病房的时间更短、住院时间更短，从而提高了患者生活质量改善的前景。
评估接受体外循环和非体外循环冠状动脉搭桥术患者的生活质量。
对患有稳定型多支冠状动脉疾病（CAD）且心室功能保留的患者，在手术前、术后6个月和12个月进行简短健康调查问卷（SF-36）。
2002年1月至2006年12月期间，共有202例患者被随机分为体外循环或非体外循环冠状动脉搭桥术组。两组的人口统计学、临床、实验室和血管造影特征相似。105例患者接受了非体外循环冠状动脉搭桥术，97例接受了体外循环冠状动脉搭桥术。在术后过程中，22例患者发生心肌梗死，29例报告有心绞痛，1例再次手术，3例发生中风。无患者死亡。通过SF-36问卷测量的生活质量在身体和心理方面两组相似。然而，男性患者在身体功能和因身体问题导致的角色限制方面有显著改善。此外，两组中的大量患者恢复了工作。
无论采用何种手术技术，所有患者的生活质量均逐步提高且早期恢复工作。除男性患者在身体功能和因身体问题导致的角色限制方面有更大改善外，两组在其他领域未发现统计学上的显著差异。
