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风险调整后的短期和长期结果,在抽血与非抽血的冠状动脉旁路手术

Matthew L Williams¹, Lawrence H Muhlbaier, Jacob N Schroder

¹Division of Cardiothoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27703, USA.

|September 15, 2005

概括

与传统的冠状动脉旁路移植 (CABG) 相比,非冠状动脉旁路移植 (OPCAB) 减少了输血,但增加了重复血管化的风险. 在这两种手术技术之间,长期存活率仍然相似.

科学领域:

心血管外科心血管外科
胸部外科手术胸部外科手术

背景情况:

无冠状动脉旁路移植 (OPCAB) 用于最大限度地降低手术重血管化的发病率.
对OPCAB与常规冠状动脉旁路移植 (CABG) 的长期结果需要进一步定义.

研究的目的:

为了比较OPCAB和CABG之间的短期和长期结果.
评估外科手术后的并发症,存活率,以及需要重复的血管化.

主要方法:

对641名OPCAB和5026名CABG患者 (1998-2003) 的回顾性分析.
用于结果分析的后勤回归和比例危险建模.
98%的随访完整性对于生存和再血管化的数据.

主要成果:

在OPCAB患者中,输血率显著降低 (OR 0.80,P=0.037).
在OPCAB和CABG组之间,长期存活率没有显著差异.
在OPCAB患者中,需要重复血管化的可能性更高 (HR1.29,P=0.020).

结论:

OPCAB与术后输血减少有关,但增加了晚期再血管化的风险.
通过大型随机对照试验进行进一步的研究是有必要的,以比较OPCAB和CABG的疗效.

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