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减少死亡率和中风与非抽动冠状动脉旁路移植手术在八岁老年人中.

Roland G Demaria1, Michel Carrier, Simon Fortier

  • 1Research Center and Department of Surgery, Montreal Heart Institute, Montreal, Quebec, Canada.

Circulation
|October 2, 2002
PubMed
概括

除冠状动脉旁路移植 (OPCAB) 手术与传统心肺旁路移植 (CPB) 相比,可以减少八岁以上患者的手术死亡率和中风. 这项研究发现,OPCAB对于需要心肌再血管化的老年患者来说是一个更安全的选择.

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科学领域:

  • 心血管外科心血管外科
  • 老年医学 老年医学
  • 外科手术的结果

背景情况:

  • 无冠状动脉旁路手术 (OPCAB) 正在获得普及,但其在患者子集中的具体益处尚不清楚.
  • 冠状动脉旁路移植 (CABG) 是心肌再血管化的常见手术.

研究的目的:

  • 为了比较冠状动脉绕道移植 (CABG) 的结果,在使用心肺绕道 (CPB) 技术的八十岁患者中,与OPCAB技术相比.
  • 确定OPCAB在接受心肌再血管化的老年患者中的潜在益处.

主要方法:

  • 这是一项回顾性研究,比较了125名八十多岁的患者,他们在1995年至1999年期间接受了分离心肌再血管化.
  • 患者被分为两组:63人接受了CABG与CPB,62人接受了OPCAB.
  • 分析的结果包括手术后的死亡率,中风,输血率和术后心肌梗塞.

主要成果:

  • 与CPB组相比,OPCAB组的手术死亡率 (4.8%对15.9%) 和中风率 (0%对6.3%) 显著降低 (P=0.04两者).
  • 在OPCAB组中,输血的患者比例较低 (72.6%与92.1%,P<0.01).
  • 多变量分析确定OPCAB是减少手术死亡率和中风 (OR=4.171) 的独立预测因素.

结论:

  • 与心肺绕道 (CPB) 相比,OPCAB手术似乎在减少八十多岁患者的手术死亡率和中风方面具有显著的好处.
  • 研究结果表明,OPCAB可能是需要心肌再血管化的老年患者的首选手术策略.