非体外循环冠状动脉旁路移植术治疗冠心病合并血液透析患者的疗效分析

洪昊; 董念国; 吴龙; 蒋雄刚

doi:10.13201/j.issn.1001-1439.2021.08.009

非体外循环冠状动脉旁路移植术治疗冠心病合并血液透析患者的疗效分析

- 华中科技大学同济医学院附属协和医院心脏大血管外科(武汉, 430022)
基金项目:
国家自然科学基金面上项目(No:81873502)

详细信息

通讯作者: 董念国,E-mail:hhdongnianguo@aliyun.com

中图分类号: R654.2

收稿日期: 2020-12-07

Outcomes of off-pump coronary artery bypass grafting surgery in patients with coronary heart disease and hemodialysis

- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

More Information

Corresponding author: DONG Nianguo, E-mail: hhdongnianguo@aliyun.com

Received Date: 07 December 2020

摘要

摘要: 目的:研究非体外循环冠状动脉旁路移植术(CABG)治疗冠心病合并血液透析患者的疗效。方法:收集2008年1月—2020年1月本中心收治的冠心病术前合并血液透析接受CABG治疗的病例资料。其中68例接受常规体外循环停跳CABG治疗(on-pump组),56例接受非体外循环CABG治疗(off-pump组)。对两组患者的住院和早期随访临床资料进行分析比较。结果:与off-pump组比较,on-pump组手术时间、术后呼吸机辅助、重症监护和住院时间均延长,用血量和术后引流量增多,肺部感染发生率上升(均P<0.05)。低心排、IABP辅助和30 d病死率在两组之间差异无统计学意义。结论:非体外循环CABG是冠心病合并血液透析患者安全有效的治疗方法,可以减少手术创伤和并发症、缩短住院时间。
- 非体外循环 /
- 冠状动脉旁路移植 /
- 血液透析
Abstract: Objective: To investigate the outcomes of off-pump coronary artery bypass grafting surgery(CABG) in patients with coronary heart disease and hemodialysis.Methods: Coronary heart disease patients with hemodialysis who underwent CABG in our hospital from January 2008 to January 2020 were included, 68 patients underwent conventional CABG(on-pump group), and 56 patients underwent off-pump CABG(off-pump group). The clinical data of hospitalization and early follow-up outcomes of the two groups were analyzed and compared.Results: Compared with the off-pump group, the operation time, postoperative ventilator assistance, length of intensive care, and hospital stay were prolonged, blood consumption and postoperative drainage volume were increased, and the incidence of pulmonary infection was increased in the on-pump group(all P < 0.05). There was no significant difference in low cardiac output, IABP, and 30-day mortality between the two groups.Conclusion: Off-pump CABG is a safe and efficacious procedure that provides more benefits for patients with coronary heart disease combined with hemodialysis, which can reduce the surgical trauma, complications, and length of hospital stay.
- off-pump /
- coronary artery bypass grafting surgery /
- hemodialysis

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