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在患有慢性阻塞性肺病的患者中,除对抗在的冠状动脉绕道移植

Karim Mohamed Mady¹, Amr Ahmed Abdou Ettish¹, Wael Mohamed Elfeky¹

¹Department of Cardiothoracic Surgery, Kafrelsheikh University,Egypt.

JPMA. The Journal of the Pakistan Medical Association

|July 24, 2023

概括

无冠状动脉旁路移植 (CABG) 为患有慢性阻塞性肺病 (COPD) 的患者提供更快的恢复. 与传统的式CABG相比,这种方法显示了减少机械通风和更短的住院时间.

科学领域:

心血管外科心血管外科
肺部医学肺部医学
医疗技术医疗技术医学技术

背景情况:

冠状动脉疾病 (CAD) 经常与慢性阻塞性肺病 (COPD) 共同存在.
由于肺功能受损,COPD患者的CAD手术治疗存在独特的挑战.
在冠状动脉旁路移植 (CABG) 期间的心肺旁路 (CPB) 可能会加剧COPD患者的呼吸道并发症.

研究的目的:

在患有缺血性心脏病和COPD的患者中,比较非抽冠状动脉旁路移植 (OPCAB) 与抽冠状动脉旁路移植 (CABG) 的术后结果.
评估CPB对这种高风险患者群体的呼吸和整体恢复的影响.

主要方法:

一项前性,随机的多中心研究,涉及60名患有缺血性心脏病和COPD的患者.
患者被随机分为两组:第一组 (内CABG) 和第二组 (外CABG).
评估的术后结果包括机械通风的持续时间,呼吸衰竭,肺炎,重症监护室 (ICU) 停留时间和整体住院时间.

主要成果:

与抽气组 (I组) 相比,非抽气组 (II组) 的机械通风持续时间 (6.97±2.25分 vs. 12.07±5.18分,p<0.001) 和ICU停留时间 (3.03±1.03天 vs. 4.17±1.64天,p<0.001) 显着较短.
整体住院时间在非组中也显著缩短 (5.93±1.17天与7.40±1.90天相比,p<0.001).
在呼吸衰竭,肺炎,心房动,ARDS,多发性溢血,乳房脱或胸脱的发病率方面,没有观察到两组之间有显著差异.

结论:

无冠状动脉旁路移植是COPD患者的有效和安全的替代方案,导致术后恢复更快.
OPCAB减少了机械通风和住院时间的持续时间,可能会减轻与心肺绕道相关的风险,在这个脆弱的人群中.

关键词:

心肺绕道,心房动,呼吸,冠状动脉,肺,慢性阻塞性,呼吸困扰,心肌缺血症,呼吸不充分,多叶流液,肺炎.

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