冠状动脉搭桥术中大隐静脉获取术“不接触”法与常规法在围术期的区别
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南京医科大学附属第一临床医院

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Hsp90的巯基亚硝基化修饰在心肌纤维化中的作用研究


Perioperative difference between "No-touch" and conventional harvesting technique for vein grafts in coronary artery
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    摘要:

    目的:探讨在不停跳冠状动脉搭桥术中,以“不接触”即No-touch法获取大隐静脉与常规技术获取大隐静脉在围手术期对患者是否产生不同的影响。 方法:本文共纳入106例行不停跳冠状动脉搭桥术的病例,其中“不接触”组为55例,常规组为51例。No-touch组使用No-touch技术获取大隐静脉桥血管,常规手术组采用常规切口采集大隐静脉桥血管。观察指标包括总手术时间、术中桥血管流量、监护室停留时间、引流量、术后肌钙蛋白、血清肌酸激酶同工酶、肌红蛋白、腿部愈合情况等。 结果:在接受非体外循环冠状动脉搭桥术的106例患者中,常规法出现1例术后死亡。两组的手术持续时间、术中静脉桥血流量、术后突发心血管事件、术后24H引流量、术后心肌标记物、腿部愈合不佳情况均无统计学差异(P<0.05)。 结论:结果表明大隐静脉获取术中“不接触”法与常规法在冠状动脉搭桥术围术期不会对患者产生不同的影响。

    Abstract:

    Objective:To investigate the perioperative difference between obtaining the great saphenous vein by "no-touch" or No-touch method and obtaining the great saphenous vein by conventional technique during off-pump coronary artery bypass grafting, whether patients have different effects. Method:A total of 106 cases of off-pump coronary artery bypass grafting were included in this study. There were 55 patients in the No-touch group and 51 patients in the conventional group, while the No-touch group harvested the saphenous vein graft with the No-touch technique, and the conventional group used the conventional incision. Observation indicators included total operation time, intraoperative bridge vessel flow, intensive care unit stay time, drainage volume, postoperative cardiac troponin, creatine kinase isoenzyme, myoglobin, and leg healing. Result:There was one death in the conventional group among the 106 patients who received off-pump coronary artery bypass grafting. There were no significant differences between two group in operation duration, intraoperative venous graft blood flow, major adverse cardiovascular events, postoperative 24-hour drainage volume, postoperative myocardial markers, and poor leg healing(P<0.05). Conclusion:These findings show that the No-touch and the conventional harvesting technique make no difference in the perioperative period of coronary artery bypass grafting.

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  • 收稿日期:2022-03-02
  • 最后修改日期:2022-07-03
  • 录用日期:2022-11-10
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