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有支架置入史的冠状动脉旁路移植患者与初次冠状动脉手术患者短期结果的比较。

Comparison of Short-Term Results between Patients Undergoing Coronary Artery Bypass Graft with a Stent-Placement History and Patients Undergoing Primary Coronary Artery Surgery.

作者信息

Hadadzadeh Mehdi, Mirahmadi Mahdiesadat, Mirzaei Masoud, Pedarzadeh Ali, Ghasemzadeh Bahram, Rahimianfar Ali Akbar

机构信息

Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Department of Cardiac Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

J Tehran Heart Cent. 2019 Apr;14(2):53-58.

Abstract

: Percutaneous coronary intervention (PCI) has become the first-choice treatment strategy the world over for patients with chronic coronary artery disorders. This study compared the effects of previous PCI procedures on the short-term postoperative results of coronary artery bypass graft surgery (CABG). This cross-sectional analytical study recruited 220 patients who underwent CABG in Afshar Hospital in the Iranian city of Yazd between March 2009 and February 2013. The mean postoperative morbidity and mortality rates, the mean postoperative left ventricular ejection fraction (LVEF), the mean hemorrhage volume, the mean serum urea level, and the mean length of stay in the intensive care unit (ICU) were compared between the PCI and non-PCI groups. Among the 220 participants, 147(66.8%) were male and 73(33.2%) were female. The mean age of the study population was 59.41±10.52 years. There was no significant difference in the risk of mortality between the 2 groups (P=0.369). The mean serum urea level was 21.14±6.52 mg/dL in the PCI group and 14.45±1.08 mg/dL in the non-PCI group (P=0.016). The mean postoperative LVEF was 43.19±8.81% in the PCI group and 45.51±8.15% in the non-PCI group (P=0.044). The mean length of stay in the ICU was 3.34±1.23 days in the PCI group and 2.22±0.56 days in the non-PCI group (P<0.001). The mean hemorrhage volume was 1113.01±428.13 mL in the PCI group and 961.42±228.31 mL in the non-PCI group (P=0.027). Previous PCI procedures did not affect the post-CABG mortality rate; however, some postoperative results were worse in the PCI group than in the non-PCI group, which should be considered before the selection of the revascularization method.

摘要

经皮冠状动脉介入治疗(PCI)已成为全球慢性冠状动脉疾病患者的首选治疗策略。本研究比较了既往PCI手术对冠状动脉旁路移植术(CABG)术后短期结果的影响。这项横断面分析研究招募了2009年3月至2013年2月期间在伊朗亚兹德市阿夫沙尔医院接受CABG的220例患者。比较了PCI组和非PCI组的术后平均发病率和死亡率、术后平均左心室射血分数(LVEF)、平均出血量、平均血清尿素水平以及在重症监护病房(ICU)的平均住院时间。在220名参与者中,147名(66.8%)为男性,73名(33.2%)为女性。研究人群的平均年龄为59.41±10.52岁。两组之间的死亡率风险无显著差异(P = 0.369)。PCI组的平均血清尿素水平为21.14±6.52mg/dL,非PCI组为14.45±1.08mg/dL(P = 0.016)。PCI组术后平均LVEF为43.19±8.81%,非PCI组为45.51±8.15%(P = 0.044)。PCI组在ICU的平均住院时间为3.34±1.23天,非PCI组为2.22±0.56天(P<0.001)。PCI组的平均出血量为1113.01±428.13mL,非PCI组为961.42±228.31mL(P = 0.027)。既往PCI手术不影响CABG术后死亡率;然而,PCI组的一些术后结果比非PCI组差,在选择血运重建方法时应予以考虑。

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