保留大隐静脉分支的Y形桥在冠状动脉旁路移植术中的应用价值研究

Application Value of Y-Shaped Bridge with Great Saphenous Vein Branch Preserved in Coronary Artery Bypass Grafting

摘要: 目的：探讨保留大隐静脉分支做天然Y形桥在冠状动脉旁路移植术中的应用价值。方法：选取研究对象为2017年12月至2019年12月在青岛大学附属医院行非体外循环下冠状动脉旁路移植术的患者100例。其中50例患者术中保留大隐静脉分支做桥血管记为观察组，其余50例患者仅保留大隐静脉主干做序贯桥记为对照组。对比两组患者术中静脉桥各吻合口血流量、搏动指数(PI)和大隐静脉使用长度，以及术后1个月、6个月、1年的左心室射血分数(LVEF)。结果：相较于对照组，观察组术中静脉桥血流量更高，PI也更优，实际应用的静脉长度也较短。两组患者术后短期(术后1个月、6个月)心功能并无明显差异，术后中期(术后1年)观察组的左心室射血分数(LVEF)明显升高。结论：在冠状动脉旁路移植术中保留大隐静脉的分支做天然Y形桥较传统单支序贯桥能提供更好的血流，提高术后左心功能，节约静脉桥长度。

Abstract: Objective: Explore the value of preserving the great saphenous vein branch as a natural Y-shaped bridge in coronary artery bypass grafting. Methods: 100 patients who underwent off-pump coronary artery bypass grafting in the Affiliated Hospital of Qingdao University from December 2017 to December 2019 were selected as the research objects. Among them, 50 patients kept the branches of great saphenous vein as bridging vessels during operation as the observation group, and the remaining 50 patients only kept the trunk of great saphenous vein as sequential bridging vessels as the control group. The blood flow, pulsatility index (PI), the length of saphenous vein, left ventricular ejection fraction (LVEF). Results: Compared with the control group, the blood flow of vein bridge in the observation group was higher, the PI was better, and the length of vein used in practice was shorter. There was no significant difference in short-term (1 month, 6 months) postoperative cardiac function between the two groups. The left ventricular ejection fraction (LVEF) in the observation group was significantly increased in the middle term (1 year) after operation. Conclusion: In coronary artery bypass grafting, preserving the saphenous vein branch as a natural Y-shaped bridge can provide better blood flow, improve postoperative left ventricular function and save the length of vein bridge.