A comparative study of clinical efficacy between off-pump and conventional coronary artery bypass grafting in treating the patients with coronary heart disease and its impact on brain natriuretic peptide
10.3760/cma.j.issn.1673-4904.2012.23.002
- VernacularTitle:非体外和体外循环冠状动脉旁路移植术治疗冠心病的临床疗效及其对脑钠肽水平影响的比较研究
- Author:
Gang MA
;
Shuting BI
;
Chunsheng HAN
- Publication Type:Journal Article
- Keywords:
Extracorporeal circulation;
Coronary artery bypass,off pump;
Natriuretic peptide,brain;
Treatment outcome
- From:
Chinese Journal of Postgraduates of Medicine
2012;35(23):5-9
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy of off-pump coronary artery bypass grafting (OPCABG) comparing with the conventional coronary artery bypass grafting (CCABG) for treating the patients with coronary heart disease (CHD) and its impact on brain natriuretic peptide (BNP).Methods One hundred and twenty-two patients undergoing elective coronary artery bypass grafting were divided into CCABG group and OPCABG group according to the surgical method.The operative condition and postoperative clinical data,postoperative complications and death of the two groups were observed.The level of BNP was detected before surgery,immediately after surgery,postoperative 6,24,72 h and 1 week.Results The operative time,postoperative mechanical ventilation time,ICU monitoring time,24 h after drainage and blood transfusion,hospital stay in OPCABG group was(210.08 ± 60.02) min,(9.01 ± 2.57) h,(32.08 ±9.17) h,(343.43 ± 98.12) ml,(341.75 ±97.64) ml,(9.70 ±2.77) d,significantly lower than those in CCABG group [(309.38 ± 88.39) min,( 15.25 ±4.36) h,(45.14 ± 12.90) h,(530.24 ± 151.50) ml,(752.90 ± 215.11 ) ml,( 15.44 ± 4.41 ) d] ( P ＜ 0.05 ).The incidence of postoperative complication of OPCABG group and CCABG group was 15.9％(10/63) and 47.5％(28/59),there was significant difference ( χ2 =14.172,P ＜ 0.01).The mortality rate of OPCABG group and CCABG group was 1.6％(1/63) and 8.5％(5/59),there was no significant difference ( x2 =3.091,P ＞ 0.05 ).The level of BNP in CCABG group before surgery,immediately after surgery,postoperative 6 h was (104.54 ±29.87),(114.74 ±32.36),( 129.10 ± 36.15 ) ng/L,and in OPCABG group was ( 103.46 ± 29.56 ),( 109.49 ± 31.28 ),( 126.42 ± 36.12 )ng/L respectively,there was no significant difference (P ＞ 0.05).The level of BNP in CCABG group postoperative 24,72 h and 1 week [(335.57 ± 95.83 ),(429.98 ± 122.85 ),(350.92 ± 100.26) ng/L] were significantly higher than those in OPCABG group [(241.22 ± 68.92 ),( 317.49 ± 90.71 ),(256.86 ± 73.39)ng/L] (P ＜ 0.05).The levels of BNP in both groups postoperative 24,72 h and 1 week were significantly higher than those before surgery (P＜ 0.05).Conclusion The OPCABG surgery is safe and effective,and has certain advantages for maintenance of cardiac function.
