我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

川崎病致冠状动脉病变外科治疗的效果分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第6期
页码:
717-719
栏目:
临床研究
出版日期:
2014-06-25

文章信息/Info

Title:
Effect analysis of surgical treatment of Kawasaki coronary artery disease
作者:
尹朝华; 李巅远; 闫 军; 李守军; 胡盛寿
(中国医学科学院、北京协和医学院心血管病研究所、阜外心血管病医院心外科，北京 100037)
Author(s):
YIN Zhao-hua;  LI Dian-yuan;  YAN Jun;  LI Shou-jun;  Hu Sheng-shou
(Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100037, China)
关键词:
冠状动脉病变;  川崎病; 心肌缺血; 心脏手术
Keywords:
coronary disease;  Kawasaki disease;  myocardial ischemia;  cardiac surgery
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:分析和讨论川崎病致冠状动脉病变外科治疗的临床效果和经验。方法： 回顾分析2004年1月~2012年12月对13例川崎病致冠状动脉病变患者的临床资料。本组患者均行冠状动脉旁路移植术。所有患者均使用乳内动脉。8例体外循环手术，5例常温手术。2例行冠状动脉瘤成形术，1例行血栓清除术。1例行二尖瓣置换术。结果： 手术死亡1例。体外循环时间41~455(137±136) min，心肌阻断时间18~117(50±37) min，桥血管数量1~3(2.1±0.8)条。随诊3个月~6年，患者症状减轻或消失。动脉瘤直径减小。结论： 冠状动脉旁路移植是治疗川崎病致冠状动脉病变的有效方法，无需同期处理冠状动脉瘤。
Abstract:
AIM:To analyze and discuss of the clinical effect and experience of surgical treatment for Kawasaki coronary disease. METHODS: Clinical data of 13 patients with Kawasaki coronary artery disease from January 2004 to December 2012 were analyzed retrospectively. All patients underwent coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) in eight patients and off-pump technique in five patients. Left internal mammary artery was used in all cases. The combined procedures included coronary aneurysmectomy in two patients, coronary artery thrombus removal in one case, and mitral valve replacement in one case. RESULTS: One 4-year-old patient died of low cardiac output syndrome and acute renal failure 19 days after operation and who underwent CABG, coronary aneurysmectomy and coronary artery thrombus removal. The age of surgical operation was 3-49(18.5±13.5) years old. All patients had serious coronary stenosis or occlusion or reversible ischemia. Cardiopulmonary bypass and aortic clamp were 41-455(137±136) min and 18-117(50±37) min, respectively. The mean number of grafts was 1-3(2.1±0.8) and all patients except one<18 years old used artery graft. During the follow-up ranging from 3 months to 6 years, clinical symptoms were alleviated or disappeared. The diameter of the coronary aneurysm decreased. CONCLUSION: CABG is an effective procedure for Kawasaki CAD, which requires no treatment of coronary aneurysm at the same time.

参考文献/References

[1]Onouchi Z,Hamaoka K,Sakata K,et al.Long-term changes in coronary artery aneurysms in patients with Kawasaki disease: comparison of therapeutic regimens[J].Circ J,2005,69(3): 265-272.
[2]Kawasaki T.Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children[J].ArerugI,1967,16(3):178-222.
[3]Tsuda E,Kamiya T,Ono Y,et al.Incidence of stenotic lesions predicted by acute phase changes in coronary arterial diameter during Kawasaki disease[J].Pediatr Cardiol,2005,26(1):73-79.
[4]Yuan SM.Cardiac surgical procedures for the coronary sequelae of Kawasaki disease[J].Libyan J Med,2012,7:19796.
[5]Tsuda E,Matsuo M,Naito H,et al.Clinical features in adults with coronary arterial lesions caused by presumed Kawasaki disease[J].Cardiol Young,2007,17(1):84-89.
[6]Newburger JW,Takahashi M,Gerber MA,et al.Diagnosis, treatment,and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association[J].Pediatrics,2004,110(17):2747-2771.
[7]Tsuda E,Kitamura S.Cooperative Study Group of Japan. National survey of coronary artery bypass grafting for coronary stenosis caused by Kawasaki disease in Japan[J].Circulation,2004,110(11 Suppl 1):1161-1166.
[8]Kitamura S,Tsuda E,Kobayashi J,et al.Twenty-five-year outcome of pediatric coronary artery bypass surgery for Kawasaki disease[J].Circulation,2009,120(1):60-68.
[9]Suda K,Mastumoto M,Miyanishi S.Intermittent heparin infusion in children with ischemic heart disease caused by Kawasaki disease［J］. Int J Cardiol, 2009, 133(3):417-419.
[10]Yamauchi H, Ochi M,Fujii M,et al Optimal time of surgical treatment for Kawasaki coronary artery disease[J].J Nippon Med Sch,2004,71(4):279-286.
[11]Tanaka H,Narisawa T,Hirano J,et al.Coronary artery bypass grafting for coronary aneurysms due to Kawasaki disease[J].Ann Thorac Cardiovasc Surg,2001,7(5):307-310.
[12]Kitamura S,Kawashima Y,Fujita T,et al.Aortocoronary bypass grafting in a child with coronary artery obstruction due to mucocutaneous lymphnode syndrome:report of a case[J].Circulation,1976,53(6):1035-1040.
[13]Yoshikawa Y,Yagihara T,Kameda Y,et al.Result of surgical treatments in patients with coronary-arterial obstructive disease after Kawasaki disease[J].Eur J Cardiothorac Surg,2000,17(5):515-519.
[14]Hwong TM,Arifi AA,Wan IY,et al.Rupture of a giant coronary artery aneurysm due to Kawasaki disease[J].Ann Thorac Surg,2004,78(2):693-695.
[15]Miyazaki A,Tsuda E,Miyazaki S,et al.Percutaneous transluminal coronary angioplasty for anastomotic stenosis after coronary arterial bypass grafting in Kawasaki disease[J].Cardiol Young,2003,13(3):284-289.

备注/Memo

备注/Memo:
收稿日期：2013-12-29.通讯作者：李巅远，主任医师，主要从事心脏外科研究Email：dianyuanli@yahoo.com
作者简介：尹朝华，副主任医师，博士Email：cams_yinzhaohua@sina.com
更新日期/Last Update: 2014-07-10