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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
侯剑峰,饶辰飞,张 恒,武恒朝,孙寒松,胡盛寿,郑 哲*.Hybrid技术治疗冠心病合并严重颈动脉狭窄的临床疗效及安全性研究[J].中华老年多器官疾病杂志,2016,15(10):725~728
Hybrid技术治疗冠心病合并严重颈动脉狭窄的临床疗效及安全性研究
Clinical efficiency and safety of hybrid revascularization for treatment of coronary artery disease in patients with concomitant severe carotid artery stenosis
投稿时间:2016-06-07  修订日期:2016-06-20
DOI:10.11915/j.issn.1671-5403.2016.10.173
中文关键词:  冠状动脉旁路移植术;颈动脉支架植入术;颈动脉狭窄;脑卒中
英文关键词:coronary artery bypass grafting; carotid artery stenting; carotid stenosis; stroke
基金项目:中央级公益性科研院所基本科研业务费(2012FWXX04);北京市优秀人才培养计划(2013D009008000004)
作者单位E-mail
侯剑峰,饶辰飞,张 恒,武恒朝,孙寒松,胡盛寿,郑 哲* 中国医学科学院阜外医院成人心脏外科,北京 100037 zhengzhe@fuwai.com 
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中文摘要:
      目的 回顾性分析颈动脉支架术(CAS)和冠状动脉旁路移植术(CABG)同期或分期Hybrid技术治疗冠心病合并严重颈动脉狭窄的临床疗效及安全性。方法 入选2008年7月至2014年9月期间中国医学科学院阜外医院成人心脏外科收治的同期或分期实施CAS和CABG的冠心病合并严重颈动脉狭窄患者274例,依据两种手术是否同期实施分为两组:同期手术组(间隔≤7 d,n=35)和分期手术组(间隔>7 d,n=239)。对两组患者的临床资料及预后进行比较分析。结果 与同期手术组相比,分期手术组患者的搭桥数量、颈动脉支架植入个数以及肾动脉支架植入个数显著增加,而呼吸机辅助时间显著减少,差异均具有统计学意义(P<0.05)。中位随访时间为45.6(28.1~65.4)个月,随访期间仅1例患者发生脑卒中而死亡。两组患者围手术期不良事件发生率间差异无统计学意义(P>0.05)。截至随访终期,Cox模型分析结果显示,是否同期手术与患者复合终点事件发生率无明显相关性(OR=0.679,95%CI:0.12~3.72;P=0.66)。结论 CAS联合CABG是治疗冠心病合并严重颈动脉狭窄的一种安全、有效的微创策略。
英文摘要:
      Objective To investigate the clinical efficiency and safety of hybrid revascularization, carotid artery stenting (CAS) with simultaneous or staging coronary artery bypass grafting (CABG), for the patients with coronary artery disease and concomitant severe carotid artery stenosis. Methods From July 2008 to September 2014, a total of 274 patients with coronary artery disease and concomitant severe carotid artery stenosis who underwent CAS and CABG at the same time or within next 7 days (simultaneous operation group, n=35) or with an interval of more than 7 days (staging operation group, n=239) were recruited in this retrospective single-center study. Their clinical data and prognosis were compared and retrospectively analyzed. Results The average numbers of bypass grafts, implanted stents in the stenotic inner carotid artery and in the renal artery were significantly larger, but the duration of mechanical ventilation was obviously shorter in the staging than in the simultaneous operation groups (P<0.05). During the median follow-up for 45.6 months (ranging from 28.1 to 65.4 months), only 1 patient died after stroke. There was no significant difference in the incidences of peri-operative adverse events between the 2 groups (P>0.05). Till the end of follow-up, Cox model analysis showed that whether simultaneous surgery or not had no obvious correlation with the incidences of composite endpoints (OR=0.679, 95%CI: 0.12-3.72; P=0.66). Conclusion CAS combined with CABG is a safe and effective micro-invasive measure for the patients with coexisting coronary artery disease and severe carotid artery stenosis.
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