高龄患者体外循环与非体外循环下CABG围手术期疗效与安全性对比研究

鞠胜杰; 彭晓波; 陈劲进; 肖颖彬

doi:10.16016/j.1000-5404.201912289

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高龄患者体外循环与非体外循环下CABG围手术期疗效与安全性对比研究

临床医学 | 更新时间：2026-01-09

- 高龄患者体外循环与非体外循环下CABG围手术期疗效与安全性对比研究
- Comparison of perioperative efficacy and safety between on-pump and off-pump coronary artery bypass grafting in elderly patients
- 第三军医大学学报 2020年42卷第9期页码：937-941
- 作者机构：
  
  400037 重庆，陆军军医大学(第三军医大学)第二附属医院心血管外科，全军心血管外科研究所
- 作者简介：
  
  [ 肖颖彬，E-mail:xiaoyb@vip.sina.com XIAO Yingbin, E-mail:xiaoyb@vip.sina.com
- 基金信息：
  
  国家科技部“十三五”慢病课题(2016YFC1300)
- DOI：10.16016/j.1000-5404.201912289
  中图分类号： R339.34;R654.1;R654.2
- 收稿：2019-12-30，
  
  修回：2020-02-04，
  
  纸质出版：2020-05-15
- 稿件说明：
移动端阅览
鞠胜杰, 彭晓波, 陈劲进, 等. 高龄患者体外循环与非体外循环下CABG围手术期疗效与安全性对比研究[J]. 第三军医大学学报, 2020,42(9):937-941.

Shengjie JU, Xiaobo PENG, Jinjin CHEN, et al. Comparison of perioperative efficacy and safety between on-pump and off-pump coronary artery bypass grafting in elderly patients[J]. Journal of Third Military Medical University, 2020, 42(9): 937-941.
鞠胜杰, 彭晓波, 陈劲进, 等. 高龄患者体外循环与非体外循环下CABG围手术期疗效与安全性对比研究[J]. 第三军医大学学报, 2020,42(9):937-941. DOI： 10.16016/j.1000-5404.201912289.

Shengjie JU, Xiaobo PENG, Jinjin CHEN, et al. Comparison of perioperative efficacy and safety between on-pump and off-pump coronary artery bypass grafting in elderly patients[J]. Journal of Third Military Medical University, 2020, 42(9): 937-941. DOI： 10.16016/j.1000-5404.201912289.

摘要

目的

通过倾向性评分匹配对比研究评价高龄患者体外循环与非体外循环下行冠状动脉旁路移植术(coronary artery bypass grafting

CABG)治疗的效果。

方法

纳入2014年6月至2019年6月在我科行冠状动脉旁路移植术且年龄大于70岁的患者301例，其中非体外循环下冠状动脉旁路移植术(OPCABG)51例，利用倾向性评分匹配法从体外循环下冠状动脉旁路移植术(ONCABG)的250例中选出51例作为对照组，对比两组患者术后恢复情况。

结果

与ONCABG组相比，OPCABG组手术死亡率、主动脉球囊反搏使用比例无统计学差异

气管插管时间、术后当日引流量、肾脏替代治疗比例显著低于ONCABG。

结论

对于高龄冠心病患者，两种手术方式均效果满意，与ONCABG相比，OPCABG在加速患者恢复、减少术后并发症等方面更有优势。

Abstract

Objective

To compare the efficiency between on- and off-pump coronary artery bypass grafting (CABG) in elderly patients by propensity score matching (PSM).

Methods

From June 2014 to June 2019

a total of 301 patients (older than 70 years) undergoing CABG in our department were recruited in this study. For 51 patients underwent off-pump CABG (OPCABG)

they were 44 males and 7 females

at an age of 70 to 83 (73.31±2.73) years. Another 51 patients including 46 males and 5 females

aged 70-78 (72.82±1.86) years

were selected from the remaining 250 patients treated with on-pump CABG (ONCABG) by PSM. Postoperative recovery was analyzed and compared between the 2 groups.

Results

The

re were no statistical differences in the mortality and cases needing intra-aortic balloon pump between the OPCABG and the ONCABG groups. But the former group had shorter endotracheal intubation (10.64±5.07

15.07±5.35 h

=0.000)

less drainage volume at the day after surgery (307.15±132.16

480.78±130.42 mL

=0.000)

and lower percentage of the patients needing continuous renal replacement therapy when compared with the ONCABG group.

Conclusion

Both OPCABG and the ONCABG surgeries are effective treatment for the elderly patients with coronary heart disease. However

OPCABG is superior to ONCABG in accelerating postoperative recovery and reducing postoperative complications.

关键词

Keywords

references

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