OPCAB

摘要： 目的:探讨研究非体外循环冠状动脉搭桥术(OPCAB)与体外循环冠状动脉搭桥术(CCABG)治疗冠心病患者的效果。方法:将100例冠心病患者根据治疗方法不同分为观察组(n=50,行OPCAB治疗)和对照分组(n=50,行CCABG治疗),比较两组患者治疗效果。结果:观察组手术时间、术后住院时间、术中出血量、24 h引流量和并发症发生率等指标均低于对照组(均P<0.05)。结论:关于冠心病治疗术式选择,采取OPCAB所获疗效优于CCABG,不仅能缩短患者手术时间,减少术中出血量,还能降低并发症发生风险。

摘要： 目的:研究对重症冠状动脉粥样硬化性心脏病(冠心病)给予非体外循环冠状动脉旁路移植术(OPCAB)的治疗效果。 方法:给予本院 30 例重症冠心病患者 OPCAB 治疗,观察治疗效果。 结果:本组患者经冠脉旁路搭桥(3.10±0.50)支,手术时间(3.54±1.14)h,手术成功率 100% ,无死亡患者。 术后机械呼吸治疗(8.92±2.40)h,引流量(425.50±75.35)ml,住院时间(17.30±4.20)d。 术后持续随访 1 年,患者均未出现心肌梗死,心绞痛基本消失。 结论:重症冠心病患者接受 OPCAB 治疗有利于提高手术成功率,达到良好的治疗效果,具有较高手术安全性。

摘要： Development of a simple, reusable stabilizer for beating heart surgery has been long overdue. Every time a disposable stabilizer is used and discarded, we add to the carbon footprint we leave behind. We had been working on developing such a stabilizer, and had finally come up with a simple indigenous (reusable) metallic stabilizer (SIMS). We have used it for over 600 consecutive off pump coronary artery bypass (OPCAB) with excellent results. The anatomy of the stabilizer is described here along with a comparison of this stabilizer with the commercially available one.

摘要： We hereby report a case of Kawasaki disease in a 32 year old male, with giant aneurysm of both coronary arteries and severe LV (left ventricular) dysfunction who underwent OPCAB (off pump coronary artery bypass grafting) two years ago. He presented with acute myocardial infarction of his anterior wall of left ventricle. He was stabilised with medical management and was taken up for surgery when his enzymes became normal. His LV function had improved over the time and now has a good ejection fraction.

摘要： 目的:非体外循环冠状旁路移植术(OPCAB)中常使用二氧化碳(CO2)雾化吹气以保证术野清晰,但CO2吹气有导致气体栓塞的风险。该研究拟回顾已发表的OPCAB术中使用CO2吹气引起冠脉气栓的临床特点。方法:以"非体外循环"、"冠状动脉旁路移植"、"CO2栓塞"、"气栓"、"气泡"为检索词检索中国知网、万方医学网、维普数据库等中文数据库。

摘要： 目的 探讨非体外循环冠状动脉旁路移植术(OPCAB)与体外循环冠状动脉旁路移植术(CABG)治疗对老年冠心病患者脏器损伤及Th1/Th2免疫平衡的影响.方法 将2014年11月~2016年11月于宜宾市第一人民医院就诊的老年冠状动脉粥样硬化性心脏病(冠心病)患者102例按随机数字表法分为两组,平均年龄为(73.5±5.4)岁.OPCAB组与CABG组各51例,两组性别、年龄等差异无统计学意义.对比两组治疗效果及手术并发症(指标包括桥血流量、输血量、血管搭桥数、气管插管时间、呼吸机使用时间、呼吸衰竭发生率、二次开胸率、新发心房颤动率、住院时间、死亡率、肺部感染发生率、急性肾衰发生率、脑梗死发生率).检测患者脏器损伤的生化指标,包括肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、血清肌酐(Scr)及尿素氮(BUN)水平及Th1/Th2免疫平衡指标,包括干扰素γ(INF-γ)、白介素-4(IL-4)、INF-γ/IL-4水平.结果 OPCAB组桥血流量、输血量、血管搭桥数、气管插管时间、呼吸机使用时间、呼吸衰竭发生率、二次开胸率、新发心房颤动率、住院时间、死亡率、肺部感染发生率、急性肾衰发生率、脑梗死发生率均明显低于CABG组(P均0.05).结论 OPCAB法与CABG法对老年冠心病患者脏器均有一定损伤,且影响机体Th1/Th2免疫平衡,但OPCAB法损伤程度小,治疗效果更佳.%Objective To investigate the influences of off-pump coronary artery bypass grafting (OPCABG) coronary artery bypass grafting (CABG) on organ damage and Th1/Th2 immune balance in elderly patients with coronary heart disease (CHD).Methods Elderly CHD patients (n=102 and average age=73.5±5.4) were chosen from the First People's Hospital of Yibin City from Nov. 2014 to Nov. 2016, and then randomly divided into OPCABG group and CABG group (eachn=51). The difference in sex and age had no statistical significance between 2 groups. The curative effects (including bypass flow volume, transfusion volume, number of bypass vessels, intubation duration and mechanical ventilation duration) and surgical complications (including incidence of respiratory failure, second chest-open surgery and new-onset atrial fibrillation, duration of hospital stays, mortality, and incidence of pulmonary infection, acute renal failure and cerebral infarction) were compared between 2 groups. The levels of biochemistry indexes of organ damage including creatine kinase-M B isoenzyme (CK-MB), cardiac troponin I (cTnI), aspertate aminotransferase (AST), alanine aminotransferase (ALT), serum creatinine (SCr) and blood urea nitrogen (BUN), and indexes of Th1/Th2 immune balance including interferon γ (IFN-γ), interleukin-4 (IL-4) and ratio of INF-γ to IL-4 (INF-γ/IL-4) were detected.Results The bypass flow volume, transfusion volume, number of bypass vessels, intubation duration and mechanical ventilation duration, and incidence of respiratory failure, second chest-open surgery and new-onset atrial fibrillation, duration of hospital stays, mortality, and incidence of pulmonary infection, acute renal failure and cerebral infarction were all significantly lower in OPCABG group than those in CABG group (allP0.05).Conclusion OPCABG and CABG both can induce organ damage and influence Th1/Th2 immune balance, while OPCABG has less damage and higher curative effect in elderly CHD patients.

摘要： Introduction: Here we will describe the actual surgical technique to perform the left mammary artery bypass to the left anterior descending artery, and the results of this operation in the Benetti Foundation in the last 20 years. Materials and Methods: The inclusion criteria for this operation were patients with a demonstrated predominant ischemia by functional test. In the patients with double, triple vessels disease or left main, the age was more than 65 years or and Euro score Risk of surgery of more than 4. The exclusion criteria were patients with more areas of ischemia and lesions that involved a considerable territory apart from the Lad and good candidates for surgery are younger than 65 years or the Euro score Risk of surgery were less than 4. Seventy patients were operated in the Foundation through LIMA to LAD Anastomosis with the MINI OPCABG technique. The average Preoperative Risk Euroscore was 3,5. Surgical Technique after open the lower part of the sternum, the left mammary artery is dissected around 8 cm. The pericardium is open and the mammary is connected to the left anterior descending. Results: Operative mortality in this series was 0%. One patient was converted to sternotomy Off Pump (1, 4%). None of the grafts were revised after the measure with the Medistim System. 55 (79%) were extubated in the operating room. The average Hospitalization stay were 60 hours (D +_17 ci 95%), 16 patients with Lima to LAD were restudied in the initially experience with 100% patency, at 144 months, 82% of the patients were alive and 68% asymptomatic. Conclusion: More clinical experience is important to find the definitive indications of this technique;and better technologies are required to be able to standardize this operation in definitive form.

摘要： 目的 非体外循环下冠状动脉搭桥术后护理效果.方法 选取我院2015年2月~2016年2月接收并行非体外循环下冠状动脉搭桥术(OPCAB)治疗的患者30例作为研究对象,研究其术后护理效果.结果 OPCAB患者住院的时间5~12天,平均住院时间(7.0±0.5)天;术后患者拔管的时间是4~24 h,平均拔管时间(13.5±3.5)h;仅有1例患者出现心率紊乱现象,经过对症处理后心率恢复正常,并发症发生率仅为3.33%;术后护理满意度评分达到(97.6±2.0)分.结论 对非体外循环下冠状动脉搭桥术患者术后提供有效的护理干预,有助于提升手术效果.

摘要： We report a successful treatment of the first reported case of Guillaine-Barre Syndrome (GBS) detected post Off Pump Coronary Artery Bypass Surgery (OPCAB). A 70-year-old man underwent OPCAB surgery for Triple Vessel Disease. In the post-operative period he developed respiratory distress with unexplained weakness in the limbs. CSF study confirmed Guillaine-Barre Syndrome. He was administered immunoglobulin therapy. The patient fully recovered and was discharged in good health.