冠状动脉旁路移植术与颈动脉内膜切除术及冠状动脉旁路移植术的比较

Aykut Şahin, Cengiz Ovalı
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摘要

简介:冠状动脉联合手术(CABG)治疗严重颈动脉狭窄仍存在争议。分期手术可根据冠状动脉病变或颈动脉病变的严重程度而改变手术优先级的决定。本研究的目的是比较我科同时手术(CEA + CABG)和单独CABG的结果。材料与方法:我们回顾性分析2010 - 2015年间行CABG和CEA + CABG的患者。如果患者同时进行了其他手术,则将其排除在研究之外。回顾性分析了294例患者(252例冠脉搭桥患者和42例联合手术患者)。结果:CABG组2例,CABG + CEA组2例发生脑卒中。两组早期脑卒中发生率比较,差异无统计学意义(p > 0.05)。CEA + CABG组1例死亡,CABG组3例死亡。颈动脉夹持时间平均为19.93±5.06 min。主动脉夹钳时间CABG组为42.89±6.38 min, CEA + CABG组为42.81±5.70 min。两组结果相似。结论:CEA联合冠脉搭桥术可以成功、安全地进行。
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Comparison of Coronary Bypass Grafting Surgery with Carotid Endarterectomy and Coronary Bypass Grafting Surgery
Introduction: Treatment of combined coronary artery surgery (CABG) and severe carotid artery stenosis is still controversial. The decision of surgical priority can change according to the severity of the coronary artery disease or carotid artery disease at staged surgery. The aim of the study is to compare the outcomes of simultaneous surgery (CEA + CABG) and CABG alone at our department. Materials and Methods: We retrospectively reviewed the CABG and CEA + CABG patients which were performed between 2010 and 2015. If the patients had simultaneous another operation, they were excluded from the study. A total of 294 patients (252 CABG patients and 42 combined surgery patients), were retrospectively examined. Results: Two patients in CABG group and two patients in CABG + CEA group developed stroke. There was no statistically significant difference between the two groups in terms of early stroke rate (p > 0.05). One patient in CEA + CABG group and three patients in CABG group died. The average carotid clamp time was 19.93 ± 5.06 minutes. Aortic clamp times were 42.89 ± 6.38 minutes in CABG and 42.81 ± 5.70 minutes in CEA + CABG patients. Results of the two groups were similar. Conclusion: Combined CEA and CABG can be performed successfully and safely in patients.
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