STS多支动脉冠脉旁路移植应用解读

doi:10.6040/j.issn.1671-7554.0.2024.0879

摘要/Abstract

摘要： 美国胸外科医师协会(Society of Thoracic Surgeons, STS)成人心脏数据库(the Adult Cardiac Database, ACSD)的数据显示:多支血管病变的冠状动脉旁路移植(coronary artery bypass grafting, CABG)术中存在多种血运重建方案,多支动脉CABG能够改善患者的长期生存率。美国多支动脉CABG手术的病例数量大约占全部CABG手术量的10%,近5年呈现上升趋势,但是远不如欧洲和澳大利亚的比例高。ACSD数据显示多支动脉桥患者围术期死亡率、主要心血管不良事件发生率均低于单支动脉桥的患者。美国不同地域、不同医院间多支动脉桥患者的数量和比例差别很大。影响外科医生应用多支动脉桥的主要因素包括:缺乏高质量的前瞻性随机研究数据、花费更长的手术时间、占用更多的医疗资源以及外科技术更加复杂。目前还需要大量有明确结论的前瞻性、随机对照研究来支持多支动脉桥得到更加广泛的应用。

关键词: 冠状动脉旁路移植, 多支动脉桥, 单支动脉桥, 桡动脉, 胸廓内动脉

Abstract: The data from the Adult Cardiac Database(ACSD)of the American Society of Thoracic Surgeons(STS)shows that there are multiple revascularization options in coronary artery bypass grafting(CABG)with multiple vessel lesions, and studies have found that multivessel CABG improves long-term survival. The number of cases of multiple artery CABG in the United States accounts for about 10% of the total number of CABG operations, which is on the rise in the past five years, but is lower than that in Europe and Australia. The data of the ACSD showed that perioperative mortality and major cardiovascular adverse events were lower in patients with multiple artery grafting than those with single artery grafting. The number and proportion of patients with multiple arterial grafting vary greatly between different regions and different hospitals in the United States. The main factors influencing the surgeons use of multiple artery grafting include the lack of high-quality prospective randomized study data, the need for longer surgical time, the need to occupy more medical resources, and the more complex surgical techniques needed. A large number of prospective, randomized controlled studies with clear conclusions are needed to support the wider application of multiple artery grafting.

Key words: Coronary artery bypass grafting, Multi-artery grafting, Single artery grafting, Radial artery, Internal thoracic artery

中图分类号:

R615

肖飞,王联群,季强. STS多支动脉冠脉旁路移植应用解读[J]. 山东大学学报 (医学版), 2025, 63(5): 6-11.

XIAO Fei, WANG Lianqun, JI Qiang. Application interpretation of STS multi-vessel coronary artery bypass grafting[J]. Journal of Shandong University (Health Sciences), 2025, 63(5): 6-11.

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