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目的:通过对比分析并发与不并发慢性肾功能不全并行不停跳冠状动脉旁路移植术(Off-pump CABG)患者病历资料,探讨慢性肾功能不全对Off-pump CABG术后近期效果的影响。方法:我中心在2009年3月~2013年03月施行Offpump CABG术中并发有慢性肾功能不全患者64例,并随机抽取同期施行手术但不并发慢性肾功能不全的患者124例,作为对照组,比较两组患者血肌酐值、年龄、性别、搭桥数目、心脏左室射血分数,监护室停留时间、术后住院时间,住院费用、手术切口愈合情况及术后病死率。结果:两组在性别、年龄、术前心脏左室射血分数、搭桥数目及病死率差异均无统计学意义,但并发慢性肾功能不全患者在监护室停留时间及住院时间较对照组延长,住院费用有所增加,手术切口愈合时间延长,差异均有统计学意义(均P<0.05)。结论:并发慢性肾功能不全的患者经过严格术前评估及加强围术期肾脏功能保护后接受Off-pump CABG术同样受益。
OBJECTIVE: To compare the clinical data of patients with and without chronic coronary insufficiency (CABG) with or without concurrent coronary artery bypass grafting (CABG) to explore the effect of chronic renal insufficiency on the short-term effect of Off-pump CABG. Methods: From March 2009 to March 2013, 64 cases of patients with chronic renal insufficiency who underwent Offpump CABG surgery were enrolled in our center. Totally 124 patients were enrolled in the randomized operation but without chronic renal insufficiency as control group The serum creatinine, age, sex, number of bypass, left ventricular ejection fraction, stay in guard room, hospital stay, hospitalization cost, surgical incision healing and postoperative mortality were compared between the two groups. Results: There was no significant difference in gender, age, preoperative left ventricular ejection fraction, number of bypass and fatality rate in both groups, but the patients with chronic renal insufficiency had longer stay and hospital stay in the care unit than the control group, Hospitalization costs increased, the healing time of surgical incision extended, the differences were statistically significant (P <0.05). CONCLUSIONS: Patients with concurrent chronic renal insufficiency also benefit from Off-pump CABG after a rigorous preoperative evaluation and enhanced perioperative renal protection.