摘要
目的使用食道超声和漂浮导管比较非体外循环不停跳冠状动脉搭桥术(off-pump-CABG)和体外循环下冠状动脉搭桥术(on-pump-CABG)患者的心脏功能状况和肺动脉压,以探知何种冠脉搭桥术式术中的心脏功能状况更优。方法采用完全随机方法将36例患者按照计算器随机数字法随机分为2组,A组为off-pump-CABG术组(n=18),B组为on-pump-CABG术组(n=18)。检测时间点设定为全部手术操作完成后、患者出手术室前,使用食道超声和漂浮导管测量肺动脉收缩压、右心室舒张末期容积、右心室射血分数和左室舒张末压。结果 2组超声心动图与漂浮导管的测量结果差异无统计学意义(P>0.05);超声心动图与漂浮导管的测量结果均显示A组的肺动脉舒张压低于B组(P<0.05),A组的冠脉搭桥术中心脏功能状况诸指标优于B组(P<0.05)。结论 off-pump-CABG和on-pump-CABG术中施行超声心动图与漂浮导管的监测,其效果基本一致;off-pump-CABG术的冠脉搭桥术中心脏功能状况诸指标优于on-pump-CABG术,其原因可能与off-pump-CABG更少的血流动力学扰动和没有血液直接接触非生理管道诱发的细胞因子瀑布有关。
ObjectiveTo compare the cardiac function and pulmonary arterial pressure of the patients undergoing surgery of off pump coronary artery bypass grafting（CABG） and on pump CABG by the esophageal ultrasound and the floating catheter,to find out what kind of coronary artery bypass grafting is better for cardiac function.MethodsThe design of this experiment used a completely randomized block design,36 patients were randomly divided into two groups：group A（off pump CABG）,group B（on pump CABG）,18 cases in each group.The detection time point set after all the operation had been completed.The pulmonary arterial systolic pressure,the right ventricular end diastolic volume,the right ventricular ejection fraction and the left ventricular end diastolic pressure were measured by the esophagus ultrasound and floating catheter.ResultsThere was no significant difference in esophagus ultrasound and floating catheter between the two groups（P〉0.05）.The results of echocardiography and floating catheter showed that the pulmonary artery diastolic blood pressure was lower in group A than that in group B（P〈0.05）.The heart function in group A was better than that of group B（P〈0.05）.ConclusionThe effect of the ultrasonic heartbeat graph and the monitoring of the floating catheter in the off pump CABG and on pump CABG are basically the same.The heart function in off pump CABG group was better than that of on pump CABG.The reason may be that the off pump CABG is less likely to be associated with the flow dynamics of the blood flow dynamics and the cell factor associated with the non physiological ducts.
作者
赵华
贾咏梅
ZHAO Hua;JIAYong-mei(Department of Cardiothoracic Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei Liber-al Arts College,Xiangyang Hubei 441021, China;Imaging Ultrasound Department,Xiangyang Central Hospital,Affiliated HosLiberal Arts College,Xiangyang Hubei 441021, China)
出处
《局解手术学杂志》
2017年第11期810-813,共4页
Journal of Regional Anatomy and Operative Surgery
基金
[基金项目]湖北省科学技术厅(EK2016D140164001294)
关键词
经食道心脏超声
漂浮导管
冠脉搭桥
心脏功能状况
肺动脉压
trans esophageal echocardiography
floating catheter
coronary artery bypass
cardiac function
pulmonary arterial pressure
