在不稳定的胸痛的情况下进行心肌再血管化
G C Kaiser1, H V Schaff, T Killip
1Department of Surgery, St. Louis University, Missouri.
Circulation
|June 1, 1989
概括
冠状动脉旁路移植 (CABG) 对于不稳定的胸痛表现出类似于稳定的胸痛的结果,但需要更好的手术前管理和心肌保护来降低风险.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 血管外科 血管外科
背景情况:
- 不稳定的胸痛在心脏外科手术中是一个重大挑战.
- 冠状动脉旁路移植 (CABG) 是一种主要的治疗方式.
- 结果和风险因素需要详细分析.
研究的目的:
- 评估CABG在患有不稳定性胸痛的患者中的疗效和安全性.
- 确定与发病率和死亡率相关的风险因素.
- 为了将结果与慢性稳定性胸痛患者的结果进行比较.
主要方法:
- 对1978年至1988年间发表的14份报告进行了系统审查.
- 包括6136名为不稳定的胸痛接受CABG的患者.
- 对手术死亡率,手术前心肌梗塞和手术后心脏输出量低的分析.
主要成果:
- 平均手术死亡率为3.7%,外科手术期间心肌梗塞9.9%,低心脏输出16%.
- 与慢性稳定性心痛相比,没有确定患病或死亡的明显风险因素.
- 包括心痛缓解,存活率和晚期心肌梗塞在内的结果与慢性稳定性心痛相比较.
结论:
- CABG在不稳定性心痛和稳定性心痛方面提供了相似的好处.
- 亚组分析显示,在不稳定性心痛中,预后不同.
- 改善手术前管理和心肌保护对于减少CABG相关并发症至关重要.
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