心肌切开撕裂治疗心肌桥的临床效果

Yong Mao, Wensheng Chen, Yalin Wei, Xinqiang Guan, Yanchun Zhang, Xiangyang Wu
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摘要

目的分析心肌切开撕裂治疗心肌桥的临床效果。方法回顾性分析兰州大学第二医院2014年1月至2018年1月29例行肌切开术患者的临床资料。共有11例患者(切口组)采用沿冠状动脉方向纵向切开心肌的传统心肌桥切开术,18例患者(撕裂组)采用纵向切开心肌并深层撕裂的心肌切口联合撕裂术。比较两组手术切开术时间、术中出血量、血管损伤分支数及脑室破裂次数。随访半年至一年,收集心电图提示的心绞痛、心肌缺血、冠状动脉CT提示的冠状动脉狭窄的临床症状。结果切开组手术切肌时间、术中出血患者数量及血管损伤分支数均高于撕裂组(P < 0.05)。随访半年至1年,两组心绞痛临床症状、心电图提示心肌缺血、冠状动脉CT提示冠状动脉狭窄差异无统计学意义(P>0.05)。结论心肌切开联合撕裂是一种手术时间短、出血风险低的手术方式,比传统的纵向切开心肌桥更有利。关键词:心肌桥;肌切开术;临床结果
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The clinical outcomes of myocardial incision and tearing for the treatment of myocardial bridge
Objective To analyze clinical outcomes of myocardial incision and tearing for the treatment of myocardial bridge. Methods A retrospective cohort study was conduct to review the clinical date of 29 patients who underwent surgical myotomy from January 2014 to January 2018 in the Second Hospital of Lanzhou University. A total of 11 patients(incision group) were experienced traditional myotomy on myocardial bridge that the myocardium was longitudinally incised along the direction of the coronary artery, while 18 patients(tearing group) were treated by myocardial incision combined with tearing that longitudinally incised myocardium and deeply tissue tearing. The operation time of surgical myotomy, the amount of bleeding, the number of branches of vascular injury and the number of ventricular ruptures during operation were compared between the two groups. After followed up half a year to one year, the clinical symptoms of angina pectoris, myocardial ischemia by electrocardiogram suggested, and coronary stenosis by coronary CT suggested were collected. Results The operation time of surgical myotomy, the amount of bleeding patients and the number of branches of vascular injury during operation in the incision group were higher than those in the tearing group(P 0.05). After followed up half a year to one year, there was no significant difference in the clinical symptoms of angina pectoris, myocardial ischemia by electrocardiogram suggested, and coronary stenosis by coronary CT suggested(P>0.05). Conclusion Myocardial incision combined with tearing is a surgical procedure with short operation time and low bleeding risk, which is more beneficial than the traditional longitudinally incised for the myocardial bridge. Key words: Myocardial bridge; Myotomy; Clinical outcome
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