不接触获取技术应用于非体外循环冠状动脉旁路移植术的早期临床效果
DOI:
作者:
作者单位:

南京医科大学第一附属医院心脏大血管外科

作者简介:

通讯作者:

中图分类号:

基金项目:

江苏省科技厅重点研发计划竞争项目


Early clinical outcomes of no-touch harvesting technique applied to off-pump coronary artery bypass grafting
Author:
Affiliation:

Department of Cardiovascular Surgery,the First Affiliated Hospital of Nanjing Medical University

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的:评价不接触获取技术与常规获取技术应用于非体外循环冠状动脉旁路移植术(CABG)的早期临床效果。方法:回顾性分析南京医科大学第一附属医院心脏大血管外科 2020 年 7 月至 2022 年 7 月行非体外循环冠状动脉旁路移植术的 120 位患者的临床资料,其中 50 例采用不接触获取技术(No-touch 组),70 例采用常规获取技术(CVH 组)。观察指标包括手术时间、静脉桥血管数量、静脉桥血管平均流量、机械通气时间、ICU监护时间,术后下肢切口愈合不良、术后急性肾损伤等并发症,以及随访 1 年后的心脏超声指标(左室射血分数、左室舒张末径和左室收缩末径)和冠状动脉CT血管成像结果。结果:两组患者手术时间、静脉桥血管数量、静脉桥血管平均流量、机械通气时间、ICU监护时间等比较均无统计学意义(P > 0.05)。No-touch 组术后 IABP 支持 5 例,下肢切口愈合不良 2 例,术后突发心血管事件 1 例。CVH 组术后 IABP 支持 2 例,术后急性肾损伤 1 例,两组均无二次开胸探查和二次气管插管情况,且术后各并发症发生率比较差异无统计学意义(P > 0.05)。两组患者术后 1 年心脏超声指标差异无统计学意义(P > 0.05)。No-touch 组术后 1 年静脉桥血管闭塞率低于 CVH 组,且两组指标差异有统计学意义(P < 0.05)。结论:与常规获取技术相比,在非体外循环冠状动脉旁路移植手术中采用不接触技术获取大隐静脉不增加手术风险,术后 1 年后桥血管通畅率较高。

    Abstract:

    OBJECTIVE: To evaluate the early clinical outcomes of no-touch harvesting technique and conventional harvesting technique applied to off-pump coronary artery bypass grafting. METHODS: The clinical data of 120 patients who underwent off-pump coronary artery bypass grafting from July 2020 to July 2022 in the Department of Cardiovascular Surgery of the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed, of which 50 cases used no-touch harvesting technique (No-touch group) and 70 cases used conventional harvesting technique (CVH group). Observation indexes included operation time, number of venous bridging vessels, average flow rate of venous bridging vessels, mechanical ventilation time, ICU monitoring time, postoperative complications such as poor healing of leg incision and postoperative acute kidney injury, as well as echocardiographic indexes (left ventricular ejection fraction, left ventricular end-diastolic and left ventricular end-systolic diameters) and coronary CT angiography results after 1 year of follow-up. RESULTS: There was no statistically significant difference in operation time, number of venous bridging vessels, average flow rate of venous bridging vessels, mechanical ventilation time and ICU monitoring time between the two groups (P > 0.05). In the No-touch group, there were 5 cases of postoperative IABP support, 2 cases of poor healing of leg incision, and 1 case of postoperative sudden cardiovascular event; in the CVH group, there were 2 cases of postoperative IABP support and 1 case of postoperative acute kidney injury; there were no cases of reoperation and reintubation in the two groups, and the difference in the incidence of postoperative complications was not statistically significant (P > 0.05). There was no statistically significant difference in the postoperative echocardiographic indexes between the two groups at 1 year after surgery (P > 0.05). The rate of venous bridge vessel occlusion in the No-touch group was lower than that in the CVH group at 1 year after surgery, and the difference between the two groups was statistically significant (P < 0.05). CONCLUSION: Compared with conventional harvesting technique, the use of no-touch harvesting technique for saphenous vein harvesting in off-pump coronary artery bypass grafting does not increase the surgical risk, and the patency rate of the bridge vessel is higher at 1 year after surgery.

    参考文献
    相似文献
    引证文献
引用本文
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2023-12-13
  • 最后修改日期:2024-03-04
  • 录用日期:2024-05-07
  • 在线发布日期:
  • 出版日期:
关闭