Coronary artery bypass without cardiopulmonary bypass.
Coronary artery bypass without cardiopulmonary bypass.
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无需体外循环的冠状动脉搭桥。
DOI：
10.1016/0003-4975(92)90074-e
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发表时间：
1992
影响因子：
4.6
通讯作者：
Patricia Gurny
中科院分区：
文献类型：
--
作者：
A. Pfister;M. Zaki;Jorge M. Garcia;L. Mispireta;P. Corso;A. Qazi;S. Boyce;T. Coughlin;Patricia Gurny
本文的目的有两个：描述我们在非体外循环(非体外循环)下进行冠状动脉旁路移植术的技术，并从死亡率和某些发病率指标方面证明该手术是安全的。关于体外循环手术的报道很少。从1985年到1990年，220名患者接受了非体外循环手术；220名非体外循环对照患者在移植物数量、左心功能和手术日期方面进行了回顾性匹配。在死亡率和十项发病率指标方面对各组进行了比较。对10个亚组进行了同样的分析。我们发现两组之间的死亡率没有统计学差异(非体外循环，1.4%[3/220]；非体外循环，2.4%[5/220])，这在所有亚组中都保持不变。非体外循环手术患者输血量明显减少(不输血：非体外循环，72.7%；非体外循环，54.6%[116/220]；Fisher‘s精确检验p=0.005)，低输血量发生率显著减少(非体外循环，5.5%[12/220]；非体外循环，12.7%[28/220]；应进一步研究哪些亚组可以在非体外循环下进行手术，以及哪些患者组(如果有的话)应限制在体外循环手术。
The purpose of this article is twofold: to describe our technique for performing coronary artery bypass grafting without cardiopulmonary bypass (off pump) and to demonstrate that this operation is safe, in terms of mortality and certain indices of morbidity. Very little has been published in regard to off-bypass operations. From 1985 through 1990, 220 patients underwent operation off bypass; 220 on-pump controls were retrospectively matched for number of grafts, left ventricular function, and date of operation. Groups were compared in terms of mortality and ten indicators of morbidity. The same analysis was performed for ten subgroups. We found no statistically significant difference between groups in mortality (off pump, 1.4%[3/220]; on pump, 2.4%[5/220]), which held across all subgroups. Patients undergoing operation off pump required blood far less often (not transfused: off pump, 72.7%[160/220]; on pump, 54.6%[116/220]; p= 0.005 by Fisher's exact test), and the low output state occurred statistically less frequently off pump (off pump, 5.5%[12/220]; on-pump, 12.7%[28/220]; p= 0.01 by Fisher's exact test). Further research should be directed to which subgroups can be operated on to advantage off pump and which, if any, groups of patients should be confined to on-bypass operations.