| 摘要: |
| ［摘要］目的 探讨冠状动脉内膜剥脱技术（CE）在冠心病外科治疗中的运用，并评估其近期效果．方法 回顾性分析2013年1月至2015年8月期间，我科手术治疗的18例冠状动脉内膜剥脱术及冠脉旁路移植术的冠状动脉弥漫性病变患者的临床资料，术后随访3个月，观察并比较患者术前、术后参数、术后恢复情况和近期随访结果，并总结CE的技术要点．结果 所有行冠状动脉内膜剥脱术的患者中，前降支6例（33.33%），对角支4例（22.22%），右冠状动脉主干4例（22.22%），后降支3例（16.67%），钝缘支1例（5.56%）．所有患者术后早期恢复良好，无并发症发生，与术前相比，LVEF显著增加，LVEDD显著缩小，心功能状况明显改善．结论 冠状动脉内膜剥脱术是弥漫性冠脉病变患者的有效治疗方法．手术对于此类患者术后近期心功能改善、逆转心肌重构有积极意义． |
| 关键词: ［关键词］弥漫性冠脉病变 冠状动脉内膜剥脱术 冠状动脉旁路移植 抗血小板治疗 |
| DOI： |
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| 基金项目:［基金项目］云南省科技厅-昆明医科大学联合专项基金资助项目（2013FB187，2013FB189）；云南省卫生科技计划项目（2014NS208，2014NS209） |
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| Application of Coronary Endarterectomy in Surgical Treatment of Coronary Heart Disease |
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WU Jian
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（Dept. of Cardiovascular Surgery，Kunming Yan’an Hospital，Kunming Yunnan 650051，China）
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| Abstract: |
| ［Abstract］Objective To study the application of coronary endarterectomy in surgical treatment of coronary heart disease，and to evaluate the early stage effect of CE plus CABG on patients with severe diffuse coronary artery stenosis. Methods Eighteen patients，who underwent coronary endarterectomy in our center and were followed up for 3 months between January 2013 and August 2015，were reviewed retrospectively and compared the group with 18 patients of their LV function，LVEDD，and cardiac function. Results Of all these 18 total coronary endarterectomies，6 cases（33.33%） were left anterior descending artery lesion，4 cases（22.22%）were diagonal branches lesion，4 cases（22.22%） involved the right coronary artery，3cases（16.67%）were posterior descending branches lesion， and 1 case（5.56%） were marginal branches lesion. Afer operation， all the patients recovered well in the early stage，without complications，LVEF and cardiac function improved significantly， LVEDD reduced significantly，compared with themselves preoperativly（P > 0.05）. Conclusion Cornary endarterectomy is an effective treatment for patients with diffuse coronary artery disease. This procedure will improve cardiac function and take a turn for the worse cardiac remodeling for patients with diffuse coronary artery disease. |
| Key words: ［Key words］Diffuse coronary artery stenosis Coronary endarterectomy Coronary artery bypass graft Antiplatelet therapy |