Page 61 - 南京医科大学自然版

第44卷第5期 南京医科大学学报（自然科学版）
2024年5月 Journal of Nanjing Medical University（Natural Sciences） ·649 ·

·临床研究·

不接触获取大隐静脉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

韩立翔，段书朋，李 芝，孙浩亮，耿 乐，魏 磊 *

南京医科大学第一附属医院心脏大血管外科，江苏 南京 210029

［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—2022 年 7 月行非体外循环冠状动脉旁路移植术的
120 例患者的临床资料，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 监护时间和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 监护时间等比较差异均无统计学意义（P > 0.05）。No⁃touch 组术后主动
脉内球囊反搏（intra⁃aortic balloon pump，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（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 年桥血管通畅率较高。
［关键词］ 不接触获取技术；大隐静脉；冠状动脉旁路移植术
［中图分类号］ R540.45 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）05⁃649⁃06
doi：10.7655/NYDXBNSN231161

Early clinical outcomes of no⁃touch saphenous vein harvesting technique applied to off⁃
pump coronary artery bypass grafting

HAN Lixiang，DUAN Shupeng，LI Zhi，SUN Haoliang，GENG Le，WEI Lei *
Department of Cardiovascular Surgery，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，
China

［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 vein graft，

average flow rate of vein graft，ventilation time，ICU stay，postoperative complications such as poor healing of leg wound and postoperative
acute kidney injury，as well as echocardiographic indexes and coronary CT angiography results after 1 year of follow⁃up. Results：There
was no statistically significant difference in operation time，number of vein graft，average flow rate of vein graft，ventilation time and
ICU stay between the two groups（P > 0.05）. In the No⁃touch group，there were 5 cases of intra⁃aortic balloon pump（IABP）support，
2 cases of poor healing of leg wound，and 1 case of postoperative cardiac 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

［基金项目］ 江苏省科技厅重点研发计划（BE2023081）
∗
通信作者（Corresponding author），E⁃mail：weileijs@163.com