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亞低溫在急性呼吸窘迫綜合征治療中的應(yīng)用前景探討
[關(guān)鍵詞] 冠狀動(dòng)脈搭橋術(shù),非體外循環(huán),左室功能低下,射血分?jǐn)?shù)
目的:總結(jié)分析25例射血分?jǐn)?shù)小于30%的冠心病患者進(jìn)行的非體外循環(huán)冠狀動(dòng)脈搭橋術(shù)。
方法:2000年2月至2001年4月進(jìn)行的選擇性O(shè)PCAB手術(shù)25例,全部經(jīng)左心室造影測(cè)定射血分?jǐn)?shù)在6-30%之間,平均25.6±5.6%。合并心梗史19例,急性心肌梗塞后1個(gè)月內(nèi)6例,不穩(wěn)定心絞痛12例。心功能II級(jí)9例,III級(jí)12例,IV級(jí)4例。冠狀動(dòng)脈造影提示兩支病變3例,三支病變22例,左主干7例。
結(jié)果:全部病例均完成OPCAB手術(shù),平均遠(yuǎn)端吻合口數(shù)目為3.9±0.8個(gè),使用主動(dòng)脈內(nèi)球囊反搏14例,其中10例均在手術(shù)中安放。手術(shù)死亡1例,于術(shù)后2月死于多器官功能衰竭。有2例術(shù)后出現(xiàn)急性左心衰,安放主動(dòng)脈內(nèi)球囊反搏后保守治療好轉(zhuǎn)。其中2例為室顫,均復(fù)蘇成功。
結(jié)論:低射血分?jǐn)?shù)患者實(shí)施OPCAB手術(shù)有良好的可行性和近期效果,而長(zhǎng)期結(jié)果仍有待進(jìn)一步觀察。
Off -Pump Coronary Artery Bypass Grafting
in Patients with Low Ejection Fraction
Wan Feng. Chen Yu, Wang Jingsheng, Wang Xinsheng, Chen Shenglong
Abstract
Objective: To analyze 25-case off-pump coronary artery bypass grafting (OPCAB) in patients with low left ventricular ejection fraction.
Method:25 case selective off pump coronary artery bypass grafting from February of 2000 to April of 2001 were analyzed, whose mean left ventricular ejection fraction by ventricular angiography was 25.6±5.6%。There were 19 cases with history of myocardial infarction, 12 case with unstable angina pectoris, 22 cases with triple vessels defect and 7 cases with left main coronary defect.
Results:OPCAB surgery were performed in all the cases. The mean number of distal anastamose was 3.9±0.8. Intra-aortic balloon pump was used in 14 cases, of which 10 cases we
[1] [2] [3] [4] [5]
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