大隐静脉顺行序贯式吻合技术在冠心病患者中的应用

目的:探讨大隐静脉(SVG)顺行序贯式吻合技术在冠心病患者中的应用价值。方法:收集我院2011年1月至2014年6月收治的78例冠心病患者,回顾性分析患者非体外循环下行SVG顺行序贯式冠状动脉旁路移植术患者的临床资料,术后随访1~3.5年,平均(2.1±1.5)年,密切观察患者治疗效果以及相应的并发症的发生情况。结果:SVG双支桥48例,三支桥20例,四支桥10例,吻合口共196个。术后测定近段血流流速(37.14±11.78)m L/min,搏动指数(PI)值(3.00±1.25)。术后出现2例低心排血量综合征,2例迟发性心脏压塞,除1例因序贯出现多脏器功能衰竭而死亡外,其余均痊愈。术后复查,SVG桥的通畅率为100%。结论:SVG顺行序贯吻合能尽快恢复心脏供血,术后通畅率高,在医生严格掌握手术技巧的前提下,可安全用于冠心病的治疗。

Application of Anterograde Sequential Anastomosis of Great Saphenous Vein for the Patients with Coronary Heart Disease

ABSTRACT Objective: To investigate the value of anterograde sequential anastomosis of great saphenous vein (SVG) for the pa- tients with coronary heart disease (CHD). Methods: The clinical data of 78 cases of patients with coronary heart disease in our hospital from January 2011 to June 2014 were retrospectively analyzed. They were given non cardiopulmonary bypass SVG antegrade sequential coronary artery bypass graft surgery, postoperatively followed-up for 1~3.5 years, the treatment effect and corresponding complications were observed. Results: 48 cases were with double bridges, 20 cases were with three bridges, 10 cases were with four bridges, and anas- tomotic stoma was 196 in total. The blood flow velocity was (37.14±11.78)mL/min and pulsatility index (PI) was (3.00±1.25)after op- eration. Low cardiac output syndrome was found in 2 cases, delayed cardiac tamponade was found in 2 cases, except 1 case died because of sequential multiple organ failure, all others recovered. The patency rate of SVG bridge was 100% in postoperative review. Conclusion: SVG antegrade sequential anastomosis can restore the blood supply to the heart as soon as possible, and the patency rate is high, which can be safely used in the treatment of coronary heart disease under the premise that doctors have strict surgical skills.