目的 分析左心室射血分?jǐn)?shù)(LVEF)<45%患者行冠狀動(dòng)脈旁路移植術(shù)(CABG)的臨床效果?!》椒ā』仡櫺苑治鲋袊?guó)醫(yī)科大學(xué)附屬第一醫(yī)院2007年6月至2010年6月423例連續(xù)行單純CABG患者的臨床資料,據(jù)LVEF值不同將患者分為兩組:A組,376例,男279例,女97例;年齡(58.6±11.4)歲,LVEF均≥45%;B組,47例,
男36例,女11例;年齡(60.7±12.1)歲,LVEF均<45%,比較兩組患者行CABG的臨床效果?!〗Y(jié)果 A組術(shù)后低心排血量發(fā)生率 [3.7% (14/376) vs. 17.0% (8/47), P<0.05] 和院內(nèi)病死率[1.6% (6/376) vs. 6.4% (3/47),P<0.05]均低于B組,且差異有統(tǒng)計(jì)學(xué)意義。術(shù)后門診或電話隨訪6~38個(gè)月,A組隨訪335例,B組隨訪41例,隨訪率共為88.9% (376/423)。A組死亡1例,死于術(shù)后17個(gè)月突發(fā)急性心肌梗死,其余患者心絞痛癥狀完全消失或減輕。B組死亡2例,1例術(shù)后9個(gè)月死于心力衰竭,另1例術(shù)后31個(gè)月死于消化道惡性腫瘤;術(shù)后6個(gè)月LVEF較術(shù)前明顯提高(51.7%±12.5% vs. 38.7%±4.6%,P<0.05),大多數(shù)患者活動(dòng)耐受力及心功能明顯改善?!〗Y(jié)論 CABG對(duì)于LVEF低下的冠心病患者是一種安全有效的治療方法,加強(qiáng)圍術(shù)期處理,有助于提高手術(shù)效果。
引用本文: 房勤,谷天祥,劉波,師恩祎,喻磊,于洋. 左心室射血分?jǐn)?shù)低下患者行冠狀動(dòng)脈旁路移植術(shù). 中國(guó)胸心血管外科臨床雜志, 2012, 19(4): 433-434. doi: 復(fù)制
1. | Rahimtoola SH, Dilsizian V, Kramer CM, et al. Chronic ischemic left ventricular dysfunction:from pathophysiology to imaging and its integration into clinical practice. JACC Cardiovasc Imaging, 2008, 1 (4):536-555. |
2. | Curtis JP, Sokol SI, Wang Y, et al. The association of left ventricular ejection fraction, mortality, and cause of death in stable outpatients with heart failure. J Am Coll Cardiol, 2003, 42 (4):736-742. |
3. | Fosbøl EL, Seibaek M, Brendorp B, et al. Long-term prognostic importance of resting heart rate in patients with left ventricular dysfunction in connection with either heart failure or myocardial infarction:the DIAMOND study. Int J Cardiol, 2010, 140 (3):279-286. |
4. | Ahmed WA, Tully PJ, Baker RA, et al. Survival after isolated coronary artery bypass grafting in patients with severe left ventricular dysfunction. Ann Thorac Surg, 2009, 87 (4):1106-1112. |
5. | Schinkel AF, Bax JJ, Delgado V, et al. Clinical relevance of hibernating myocardium in ischemic left ventricular dysfunction. Am J Med, 2010, 123 (11):978-986. |
6. | Zaky SS, Hanna AH, Sakr Esa WA, et al. An 11-year, single-institution analysis of intra-aortic balloon pump use in cardiac surgery. J Cardiothorac Vasc Anesth, 2009, 23 (4):479-483. |
7. | Abu-Omar Y, Taggart DP. The present status of off-pump coronary artery bypass grafting. Eur J Cardiothorac Surg, 2009, 36 (2):312-321. |
8. | 李京倖, 顧承雄, 韋華, 等. 心功能不全冠心病患者非CPB冠狀動(dòng)脈旁路移植術(shù)的療效分析. 中國(guó)胸心血管外科臨床雜志, 2011, 18 (2):157-159.. |
- 1. Rahimtoola SH, Dilsizian V, Kramer CM, et al. Chronic ischemic left ventricular dysfunction:from pathophysiology to imaging and its integration into clinical practice. JACC Cardiovasc Imaging, 2008, 1 (4):536-555.
- 2. Curtis JP, Sokol SI, Wang Y, et al. The association of left ventricular ejection fraction, mortality, and cause of death in stable outpatients with heart failure. J Am Coll Cardiol, 2003, 42 (4):736-742.
- 3. Fosbøl EL, Seibaek M, Brendorp B, et al. Long-term prognostic importance of resting heart rate in patients with left ventricular dysfunction in connection with either heart failure or myocardial infarction:the DIAMOND study. Int J Cardiol, 2010, 140 (3):279-286.
- 4. Ahmed WA, Tully PJ, Baker RA, et al. Survival after isolated coronary artery bypass grafting in patients with severe left ventricular dysfunction. Ann Thorac Surg, 2009, 87 (4):1106-1112.
- 5. Schinkel AF, Bax JJ, Delgado V, et al. Clinical relevance of hibernating myocardium in ischemic left ventricular dysfunction. Am J Med, 2010, 123 (11):978-986.
- 6. Zaky SS, Hanna AH, Sakr Esa WA, et al. An 11-year, single-institution analysis of intra-aortic balloon pump use in cardiac surgery. J Cardiothorac Vasc Anesth, 2009, 23 (4):479-483.
- 7. Abu-Omar Y, Taggart DP. The present status of off-pump coronary artery bypass grafting. Eur J Cardiothorac Surg, 2009, 36 (2):312-321.
- 8. 李京倖, 顧承雄, 韋華, 等. 心功能不全冠心病患者非CPB冠狀動(dòng)脈旁路移植術(shù)的療效分析. 中國(guó)胸心血管外科臨床雜志, 2011, 18 (2):157-159..