中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (44): 8339-8342.doi: 10.3969/j.issn.1673-8225.2010.44.042

• 器官移植临床实践 clinical practice of organ transplantation • 上一篇    下一篇

采集大隐静脉为冠状动脉旁路移植桥血管：间断小切口与传统长切口的优缺点比较

魏育涛1,2，陈新忠1，董念国1，朱佳龙2，罗  波2，侯  量2   

  1. 1 华中科技大学同济医学院协和医院心外科，湖北省武汉市   430022；2 新疆石河子大学医学院一附院心胸外科，新疆维吾尔族自治区石河子市   832008
  • 出版日期:2010-10-29 发布日期:2010-10-29
  • 通讯作者: 陈新忠，博士，主治医师，华中科技大学同济医学院协和医院心外科，湖北省武汉市 430022 wytgyh@163.com
  • 作者简介:魏育涛☆，男，1974年生，内蒙古自治区乌兰浩特市人，华中科技大学在读博士，主治医师，主要从事冠心病和心肌保护方面的研究， wytgyh@163.com

Collection of greater sapheous vein for coronary bypass grafting: Multiple interrupted incisions versus a single incision

Wei Yu-tao 1,2, Chen Xin-zhong1, Dong Nian-guo1, Zhu Jia-long2, Luo Bo2, Hou Liang2   

  1. 1 Department of Cardiovascular Surgery, Union Hospital, Tongji Medical Collage, Huazhong University of Science and Technology, Wuhan  430022, Hubei Province, China; 2 Department of Thoracic and Cardiovascular Surgery, First Hospital Affiliated to Medical College of Shihezi University, Shihezi  832008, Xinjiang Uygur Autonomous Region, China
  • Online:2010-10-29 Published:2010-10-29
  • Contact: Chen Xin-zhong, Doctor, Attending physician, Department of Cardiovascular Surgery, Union Hospital, Tongji Medical Collage, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China wytgyh@163.com
  • About author:Wei Yu-tao☆, Studying for doctorate, Attending physician, Department of Cardiovascular Surgery, Union Hospital, Tongji Medical Collage, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China; Department of Thoracic and Cardiovascular Surgery, First Hospital Affiliated to Medical College of Shihezi University, Shihezi 832008, Xinjiang Uygur Autonomous Region, China wytgyh@163.com

PDF

367

摘要：

背景：在冠状动脉旁路移植过程中，大隐静脉仍为最常用的桥血管材料，但采集难度较高。
目的：探讨冠状动脉旁路移植中使用间断小切口及传统长切口采集大隐静脉的优缺点。
方法：纳入258例采集大隐静脉的冠状动脉旁路移植患者，其中间断小切口法采集大隐静脉112例，传统长切口法146例。观察采集大隐静脉时间、切口长度、缝合时间、总手术时间及术后切口并发症发生率。
结果：间断小切口组采集大隐静脉时间长于传统长切口组(P < 0.05)。切口长度、缝合时间明显短于传统长切口组(P < 0.01)，总手术时间两组比较，差异无显著性意义(P > 0.05)。术后12 d腿部切口间断小切口组并发症发生率明显小于传统长切口组(P < 0.01)，在合并糖尿病患者中，传统长切口组腿部切口并发症发生率明显高于间断小切口组(P < 0.01)。提示，虽然间断小切口采集大隐静脉时间较长，但腿部并发症发生率明显减少，尤其适合于冠心病合并糖尿病患者。

关键词: 冠状动脉旁路移植, 血管材料, 大隐静脉, 间断小切口, 传统长切口, 比较

Abstract:

BACKGROUND: The greater saphenous vein is common used as bypass grafts during coronary bypass grafting, but it is hard to collect.
OBJECTIVE: To investigate advantages and disadvantages between multiple interrupted incisions and traditional single incision in harvesting the greater saphenous vein.
METHODS: Harvesting time of great saphenous vein, total incision length, suture time, total operation time and incidence of the post operative wound complications were observed in 258 coronary artery bypass grafting patients, who underwent great saphenous vein harvesting by either multiple interrupted incisions (n=112) or traditional single incision (n=146) .
RESULTS AND CONCLUSIONS: Harvesting time of great saphenous vein by using the interrupted incision was significant longer than that using traditional single incision (P < 0.05). However, suture time of the interrupted incision group was shorter than those in the traditional single incision group (P < 0.01). There was no difference between two groups in total operation time (P > 0.05). Complication rate in 12 days after the operation of the leg wound in interrupted incision group was significantly less than that in the traditional single incision group (P < 0.01). Complication rate of the traditional single group for patients with diabetes was significantly higher than that in the interrupted incision group (P < 0.01). Interrupted incisions significantly reduced incidence of leg complications, especially for patients with diabetes and complicated coronary heart disease, although it increased harvesting time of the great saphenous vein.

中图分类号: