分站式杂交手术治疗冠状动脉多支血管病变.pdfVIP

90 中国循环杂志 2014 年 2 月 第 29 卷 第 2 期（总第 188 期）Chinese Circulation Journal，February，2014，Vol. 29 No.2（Serial No.188） 冠心病研究 分站式杂交手术治疗冠状动脉多支血管病变 凌云鹏，卢明喻，鲍黎明，杨威，马玉良，刘健，王伟民 摘要 目的： 总结左胸小切口冠状动脉旁路移植术（MIDCAB）与经皮冠状动脉介入治疗（PCI）相结合的分站式杂交 （Hybrid）手术治疗冠状动脉多支血管病变的临床经验。 方法： 2012-05 至 2013-10，87 例患者接受 MIDCAB，其中 63 例为单纯 MIDCAB 手术（单纯 MIDCAB 组 ），24 例患者接受 MIDCAB 和 PCI 相结合的分站式 Hybrid 手术（Hybrid 组 ）。Hybrid 组冠状动脉造影提示严重的前降支病变， 合并回旋支、右冠状动脉的病变。Hybrid 组在 MIDCAB 围术期接受严格的抗凝和抗血小板治疗。 结果： 24 例分站式 Hybrid 手术均顺利完成。围术期无死亡及严重并发症。术后胸腔引流量 , 单纯 MIDCAB 组与 Hybrid 组相比差异无统计学意义 [（382±138）ml vs （520±190）ml， P =0.47]。随访 1~11 个月，两组均无死亡病例， 无心肌梗死或心绞痛发生。Hybrid 组 23 例患者术后冠状动脉造影检查均提示乳内动脉桥通畅。 结论： 执行严格抗凝和抗血小板治疗的分站式 Hybrid 手术安全可行。 关键词 冠状动脉旁路移植术；微创；杂交手术；经皮冠状动脉介入治疗 The Clinical Experience of 2-staged Hybrid Procedure for Performing the Coronary Artery Revascularization LING Yun-peng, LU Ming-yu, BAO Li-ming, YANG Wei, MA Yu-liang, LIU Jian, WANG Wei-min. Department of Cardiac Surgery, Peking University People’s Hospital, Beijing (100044), China Corresponding Author: LING Yun-peng, Email: yunpengling99@ Abstract Objective: To summarize the clinical experience of coronary artery bypass grafting via left anterior small thoracotomy (MIDCAB) and percutaneous coronary intervention (2-staged hybrid procedure) for treating the patients with multi- coronary branch lesions. Methods: A total of 87 patients who received MIDCAB in our hospital from 2012-05 to 2013-10 were summarized. The patients were divided into 2 groups, MIDCAB group, n =63 patients with only MIDCAB procedure, and Hybrid group, n =24 patients with 2-staged hybrid procedure. Coronary angiography (CAG) indicated that the patients in Hybrid group had serious lesions of left