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|

70岁以上老年患者冠状动脉旁路移植术临床结果及10年随访分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2016年第3期
页码:
319-322,329
栏目:
临床研究
出版日期:
2016-01-05

文章信息/Info

Title:
Clinical outcome of coronary artery bypass in patients≥70 years old and analysis of 10-year follow-up
作者:
胡佳心; 阮新民; 林 宇
（广东省中医院大学城医院心血管二科，广东 广州 510105）
Author(s):
HU Jia-xin;  RUAN Xin-min;  LIN Yu
(Department of Second Cardiovascular, Universities Town Hospital of Guangdong Province Hospital of T.C.M., Guangzhou 510105, Guangdong, China)
关键词:
老年患者; 冠脉搭桥术; 长期随访
Keywords:
older patients;  coronary artery bypass;  long term follow-up
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 观察70岁以上冠状动脉旁路移植术（CABG）患者的特点及术后长期生存状况。方法 回顾性总结分析94例70岁以上（含70岁）CABG患者术前、术中、术后和10年随访资料，并以192例70岁以下CABG患者作为对照组进行比较分析。结果 老年患者；冠脉搭桥术；长期随访①平均远端吻合口数两组无明显差别。②术后气管插管时间、住院时间、肺部感染率和肾功能不全等发生率，≥70岁组显著多于<70岁组。③术后10年随访结果显示≥70岁组左室射血分数（LVEF）值明显低于<70岁组。≥70岁组术后10年LVEF值比术前明显降低。④10年内总病死率、因心脏原因病死率和因心脏以外原因病死率，≥70岁组均显著高于<70岁组。结论 ①≥70岁的患者术后并发症多，康复较长；②高龄患者术后长期生存质量相对较差，病死率也比较高。
Abstract:
AIM To explore the role of coronary artery bypass grafting in septuagenarians. METHODSPreoperative, operative and postoperative data of 94 patients aged≥70 years and data of 10-year follow-up were statistically analyzed, which compared with that of 192 cases aged<70 years. RESULTSThe mean distal anastomoses was not significant between groups. Intubation time, postoperative stay, morbidity of renal function failure and pulmonary infection were longer in the group≥70 years of age than in the<70 year-old group. EF value in the group≥70 years of age was higher than in the group<70 years of age. Ten-year mortality follow-up was significantly higher in the group≥70 years of age than in the group<70 years of age. CONCLUSIONSeptuagenarians had higher morbidities of chronic obstruction pulmonary disease and renal function disease in preoperation, and had more complications and longer postoperative recovery time. Coronary artery bypass grafting (CABG) in patients≥70 years of age can be performed with low mortality and significant symptomatic benefit. Patients should not be denied CABG because of age alone. Survival quality of life in patients≥70 years of age was poorer than in the group<70 years of age.

参考文献/References

[1]Edwards FH,Clark RE,Schwartz M.Coronary artery bypass grafting: the society of thoracic surgeon national data-base experience[J].Ann Thorac Surg,1994,57(1):12-19.
[2]刘 申，赵伟霞，王辉山，等.高龄患者行心脏不停跳冠状动脉旁路移植术的早期疗效分析[J].吉林医学,2014,35(25):5658-5660.
[3]赵宇阳，贺玉泉.50例高龄冠心病患者的手术治疗[J].吉林医学,2013,34(8):1511.
[4]陶 杰，张桂敏，蔡 冰，等.心脏不停跳冠状动脉搭桥术在老年人中应用的临床效果观察[J].昆明医学学报,2010,31(4):80-82.
[5]王 强，姜 楠，王联群，等.高龄病人冠状动脉搭桥术的临床应用[J].中西医结合心脑血管病杂志, 2008, 6(5):611-612.
[6]吴秀华. 90例老年冠心病患者冠状动脉搭桥术临床分析［J］. 中外医疗,2013,25(1):76-78.
[7]Tu JV,Japlal SB,Naylor CD.Multicenter validation of a risk index for mortality,intensive care unit stay,and overall hospital length of stay after cardiac surgery. Steering Committee of the Provincial Adult Cardiac Care Network of Ontario[J].Circulation,1995,91(3):677-684.
[8]Parsionnet V, Dean D,Bernstein AD.A method of uniform stratification of risk for evaluating the results of surgery in acquired adult heart disease[J].Circulation,1989,79(6 Pt 2):12-13.
[9]Salomon NW,Page US,Bigelow JC,et al.Coronary artery bypass grafting in elderly patients[J].J Thorac Cardiovasc Surg,1992,101(2):209-218.
[10]吕 晓，张 园.高龄冠状动脉搭桥术后下呼吸道感染菌群分布及耐药性的研究[J].中国医学创新,2013,10(3):132-133.
[11]Tu JV,Sykora K,Naylor CD.Assessing the outcomes of coronary artery bypass graft surgery: how many risk factors are enough? Steering Committee of Cardiac Care Nework of Ontario[J].J Am Coll Cardiol,1997,30(5):1317-1323.
[12]Ura M,Sakata R, Ueyama K.Coronary artery bypass surgery in patients over 80 years of ages[J].Cardiovascular surgery,1995,1(supple 1):51.
[13]Sakamoto S,Matsubara J,Matsubara T,et al.Coronary artery bypass grafting in octogenarians[J].Cardiovascular surgery,2001,9(5):487-491.
[14]Masya K,Masahiro E,Fumitaka Y,et al.Long-term results of coronary artery bypass grafting in elderly Japanese patients[J].Ann Thorac surg,1995,60(3):576-579.
[15]Ascione R,Rees K,Santo K,et al.Coronary artery bypass grafting in patients over 70 years old:the influence of age and surgical technique on early and mid-term clinical outcomes[J].Eur J Cardio-thorac Surg,2002,22(1):124-128.
[16]刘俊英,储荣仁,蒋大中,等.老年人冠脉搭桥术后急性认知障碍14例报告[J].天津医药,2002,8(8):465.
[17]于钦军, 曹 莉.老年病人冠状动脉搭桥术后神经功能障碍的初步探讨[J].中华麻醉学杂志,2002,22(5):261-263.
[18]Morgan JM,Gray HH,Clague JC.Coronary arterial surgery in the elderly:its effect in the relief of angina[J].International Journal of Cardiology,1989,23(3):327-333.
[19]刘到萍. 冠状动脉搭桥术患者并发精神障碍的影响因素分析[J].解放军医院管理杂志,201421(5):420-421.

备注/Memo

备注/Memo:
收稿日期：2015-06-06.
基金项目：广东省科技计划项目资助(20140212)
作者简介：胡佳心，副教授，博士 Email:1453386845@qq.com
更新日期/Last Update: 2016-01-07