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采用桥接技术进行冠状动脉旁路移植术时,取大隐静脉肢体的临床并发症。

Clinical complications of limb undergone harvesting of great saphenous vein for coronary artery bypass grafting using bridge technique.

作者信息

Belczak Cleusa Ema Quilici, Tyszka André Luiz, Godoy Jose Maria Pereira de, Ramos Rubiana Neves, Belczak Sergio Quilici, Caffaro Roberto Augusto

机构信息

Faculty of Medical Sciences, of Santa Casa of São Paulo.

出版信息

Rev Bras Cir Cardiovasc. 2009 Jan-Mar;24(1):68-72. doi: 10.1590/s0102-76382009000100013.

Abstract

OBJECTIVE

The aim of this study was to assess clinical complications of limbs undergone harvesting of the great saphenous vein for venous coronary artery bypass graft surgery using bridge technique.

METHODS

Fourty-four patients who had undergone CABG using the great saphenous vein harvested by the bridge technique over more than 3 months ago were randomly selected. The exclusion criteria were the harvesting of both saphenous veins, prior saphenectomy of the contralateral limb, edema caused by a systemic etiology, such as heart, renal, thyroid or hepatic diseases and venous insufficiency of the lower limbs as characterized by swollen varicose veins both with and without trophic changes. The age, gender, diabetes, time of surgery and occurrence of complications, such as edema, paresthesia, infection, lymphorrhea, erysipelas and deep venous thrombosis, were assessed. The assessment was clinic and diagnosis of the diabetes was performed by the preoperative exams. The chi-square, Fisher and Student's t tests were used for statistical analysis with an alpha error of 5%.

RESULTS

The time between surgery and assessment ranged between 3 and 187 months with a mean of 47.3+/-42.5 months. Infections of the saphenous harvest site were detected in 25% of the cases, edema in 52.3%, paresthesia in 29.5%, erysipelas in 9.1%, lymphorrhea in 4.5% and deep venous thrombosis in 2.3%. There was no association between diabetes and complications.

CONCLUSION

The saphenous vein harvesting using bridge technique for coronary artery bypass grafting does not eliminate clinical complications, such as paresthesia, infection and edema of the saphenous vein harvesting site.

摘要

目的

本研究旨在评估采用桥接技术采集大隐静脉用于冠状动脉搭桥手术的肢体的临床并发症。

方法

随机选取44例在3个多月前采用桥接技术采集大隐静脉进行冠状动脉搭桥手术的患者。排除标准包括双侧大隐静脉采集、对侧肢体先前已行大隐静脉切除术、由心脏、肾脏、甲状腺或肝脏疾病等全身性病因引起的水肿以及以下肢静脉曲张伴或不伴有营养改变为特征的下肢静脉功能不全。评估患者的年龄、性别、糖尿病情况、手术时间以及并发症的发生情况,如水肿、感觉异常、感染、淋巴漏、丹毒和深静脉血栓形成。评估为临床评估,糖尿病的诊断通过术前检查进行。采用卡方检验、Fisher检验和Student t检验进行统计分析,α错误率为5%。

结果

手术与评估之间的时间间隔为3至187个月,平均为47.3±42.5个月。在25%的病例中检测到大隐静脉采集部位感染,52.3%出现水肿,29.5%出现感觉异常,9.1%出现丹毒,4.5%出现淋巴漏,2.3%出现深静脉血栓形成。糖尿病与并发症之间无关联。

结论

采用桥接技术采集大隐静脉用于冠状动脉搭桥手术并不能消除大隐静脉采集部位的感觉异常、感染和水肿等临床并发症。

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