【摘要】：目的分析75歲以上高齡患者行非體外循環(huán)下冠脈旁路移植術(OPCAB)的遠期療效及其危險因素。方法 2000年11月~2013年11月,97例75歲以上高齡患者由同一術者完成非體外循環(huán)下冠脈旁路移植術。統(tǒng)計重癥監(jiān)護病房(ICU)時間、機械通氣時間、術后并發(fā)癥發(fā)生率及死亡率等圍術期結(jié)果。出院后隨訪包括全因死亡及主要心腦血管不良(MACCE)事件(心肌梗死、腦血管事件、重復再血管化)。結(jié)果圍術期死亡3例,在院死亡率3%,隨訪成功率93.81%,隨訪時間為(29-192)(95.61±34.07)個月。10年生存率為62%,10年MACCE事件免除率為47.4%。隨訪期間6例(6.8%)患者進行了重復再血管化,12例(12.37%)患者出現(xiàn)腦血管事件,5例(5.15%)出現(xiàn)心梗。Logistic回歸分析顯示術前合并高血壓(OR=1.388,P=0.043)、糖尿病(OR=1.692,P=0.017)是高齡患者OPCAB術后遠期MACCE事件的獨立風險預測因素,而不完全再血管化并不會增加術后主要心腦血管不良事件(MACCE)事件發(fā)生率。結(jié)論高齡冠心病患者行非體外循環(huán)下冠脈旁路移植術是一種安全有效的手術方法,遠期效果滿意。高血壓、糖尿病是高齡患者OPCAB術后發(fā)生MACCE事件的危險因素,但術后良好地控制血壓及血糖可以有效降低MACCE事件的發(fā)生率,而不完全再血管化并不會對遠期療效產(chǎn)生不良影響。
[Abstract]:Objective to analyze the long-term efficacy and risk factors of off-pump coronary artery bypass grafting (OPCAB) in patients over 75 years old. Methods from November 2000 to November 2013, 97 patients over 75 years old underwent off-pump coronary artery bypass grafting. The perioperative results of (ICU) time, mechanical ventilation time, postoperative complications and mortality in intensive care unit (ICU) were counted. Follow-up after discharge included all-cause death and major cardiovascular and cerebrovascular adverse (MACCE) events (myocardial infarction, cerebrovascular events, repeated revascularization). Results three cases died during perioperative period, the mortality in hospital was 3%, the success rate of follow-up was 93.81%, the follow-up time was (29 鈮，

本文編號：2505132