[患者的手术策略 结合症状的动脉和冠状动脉病变]
A N Vachev1, O V Tereshina1, O V Dmitriev1
1Samara State Medical University of the Ministry of Health of the Russian Federation, 443099, Samara, Russian Federation.
Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery
|February 28, 2026
概括
症状性动脉和冠状动脉疾病的手术治疗显示出类似的结果,无论是在一个或两个阶段进行. 不良事件的关键风险包括先前的过渡性缺血性发作和术后出血.
科学领域:
- 心血管外科心血管外科
- 神经学 神经学
- 血管外科 血管外科
背景情况:
- 症状同时出现的动脉和冠状动脉病变的治疗是有争议的,缺乏随机试验数据.
- 在动脉和冠状动脉中显著的症状性疾病需要仔细验证手术策略.
研究的目的:
- 为了验证患者的手术策略具有显著的症状的动脉和冠状动脉病变.
- 比较一阶段与两阶段手术干预的结果.
主要方法:
- 对117名患有症状性动脉和冠状动脉疾病的患者进行前性队列研究.
- 患者接受了单阶段手术 (心状动脉末端切除 + 冠状动脉旁路移植) 或两阶段手术.
- 主要终点包括术后中风,心肌梗塞和死亡率.
主要成果:
- 在一阶段和两阶段手术组之间心肌梗塞,中风或死亡率没有显著差异 (p>0.05).
- 术后中风风险与之前的过渡性缺血性心脏病发作 (TIA) 相关 (OR 18.400).
- 术后心肌梗塞风险与术后出血和腹切割相关 (OR 12,333).
- 患者死亡风险与之前的TIA相关 (OR 7.360).
结论:
- 一阶段和两阶段的手术方法在症状性动脉和冠状动脉疾病中产生类似的术后结果.
- 手术前6个月内过渡性缺血性发作是不良事件的主要危险因素.
- 术后出血与椎切除术相结合显著增加死亡风险.
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