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|本期目录/Table of Contents|

老年患者体外与非体外循环行冠状动脉旁路移植术对围术期血气的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2006年第2期
页码:
198-200，210
栏目:
临床研究
出版日期:
2006-03-01

文章信息/Info

Title:
Effect of onpump and offpump coronary bypass surgery on perioperative blood gases in elderly patients
作者:
王强; 陈绍洋; 陈敏; 巩固; 熊利泽; 雷毅; 白晓光
第四军医大学西京医院麻醉科，陕西 西安 710032
Author(s):
WANG Qiang;  CHEN Shao-yang;  CHEN Min;  GONG Gu;  XIONG Li-ze;  LEIYi;  BAI Xiao-guang
Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi′an, Shaanxi 710032, China
关键词:
冠状动脉旁路移植手术; 非体外循环; 血气; 老年患者
Keywords:
coronary artery bypass grafting;  off-pump;  blood gas;  elderly
分类号:
R543.3
DOI:
-
文献标识码:
A
摘要:
目的 比较非体外循环(off-pump)和体外循环(on-pump)冠状动脉旁路移植手术(CABG)对年龄大于65岁老年患者围术期血气的影响。方法 32例患者接受CABG手术，其中16例采用off-pump，16例采用传统的on-pump，收集两组患者术前肺功能、手术时间、旁路移植血管数、气管插管留置时间和ICU留住时间。测定患者术前、手术开始、手术结束时和术后24、48、72 h的动脉血气。 结果 两组患者术前肺功能、手术时间、旁路移植血管数无明显差异，但off-pump组的气管插管留置时间和ICU留住时间均明显短于on-pump组(P<0.05)。两组患者术前、手术开始和术后48、72 h的动脉血气相似，但是手术结束时on-pump组PaO2和红细胞压积(Hct)明显低于offpump组(P<0.05)；术后24 h on-pump组PaO2仍显著低于off-pump组(P<0.05)。结论 与传统的on-pump CABG相比，off-pump可改善年龄大于65岁老年患者术后早期的血气，并能缩短ICU留住时间。
Abstract:
AIM To compare the effects of on-pump and off-pump coronary bypass surgery on blood gases in patients over 65 years. METHODS Sixteen patients in on-pump group underwent coronary artery bypass graft (CABG) with cardiopulmonary bypass(CPB) and the other 16 patients in offpump group without CPB. Respiratory function test and arterial blood gas analyses were performed preoperatively. Duration of operation, number of grafts and length of ICU stay was recorded. Arterial blood gas at the onset of operation, at the end of operation and 24 h, 48 h and 72 h after operation were measured. RESULTSThere was no significant difference in demographic data, surgical characteristics and preoperative respiratory function between two groups. However, the length of intubation and ICU stay were shorter in off-pump group than in on-pump group(P<0.05). The arterial blood gas analyses before operation, at the onset of operation, 48 h and 72 h after operation were not significantly different between two groups. PaO2 and Hct at the end of operation in on-pump group were lower compared with off-pump group(P<0.05). PaO2 in on-pump group remained lower 24 h after operation than that in off-pump group(P<0.05). CONCLUSION Off-pump technique may help to improve arterial blood gases shortly after operation and respiratory functions in patients over 65 years undergoing CABG and thus shorten intubation time and length of ICU stay.

参考文献/References

［1］Ng CS, Wan S, Yim AP, et al. Pulmonary dysfunction after cardiac surgery［J］. Chest, 2002,121:1269-1277.

［2］ Bonacchi M, Prifti E, Giunti G, et al. Respiratory dysfunction after coronary artery bypass grafting employing bilateral internal mammary arteries: the influence of intact pleura［J］. Eur J Cardiothorac Surg, 2001,19:827-833.

［3］ Taggart DP. Respiratory dysfunction after cardiac surgery: effects of avoiding cardiopulmonary bypass and the use of bilateral internal mammary arteries［J］. Eur J Cardiothorac Surg, 2000,18:31-37.

［4］ 陈敏，巩固，董辉，等. 非体外循环和体外循环冠状架桥的效果和资源利用的比较［J］. 心脏杂志, 2003,15:144-146.

［5］ Angdin M, Settergren G, Vaage J. Better preserved pulmonary endotheliumdependent vasodilation with offpump coronary surgery［J］. Scand Cardiovasc J, 2001,35:264-269.

［6］ Cimen S, Ozkul V, Ketenci B, et al. Daily comparison of respiratory functions between onpump and offpump patients undergoing CABG［J］. Eur J Cardiothorac Surg, 2003，23：589-594.

［7］ Murray JF, Matthay MA, Luce JM, et al. An expanded definition of the adult respiratory distress syndrome［J］. Am Rev Respir Dis, 1998,138:720-723.

［8］ Asimalopoules G, Taylor KM, Smith PLC, et al. Prevalence of acute respiratory distress sydrome after cardiopulmonary bypass［J］. Thorac Cardiovascu Surg, 1999,117:620-621.

［9］ Kochamba GS, Yun KL, Pfeffer TA, et al. Pulmonary abnormalities after coronary arterial bypass grafting operation: cardiopulmonary bypass versus mechanical stabilization［J］. Ann Thorac Surg, 2000,69:1466-1470.

［10］Sohrabi F, Mispireta LA, Fiocco M, et al. Effects of offpump coronary artery bypass grafting on patient outcome［J］. J Investig Med, 2003,51:27-31.

备注/Memo

备注/Memo:
收稿日期：2004-11-01.基金项目：全军医学科研“十五”计划项目资助（No.01M118）作者简介：王强，讲师，博士生 Tel：(029)84775343Email：wangqiang@fmmu.edu.cn
更新日期/Last Update: