非体外循环搭桥术的短期并发症较传统方法少
【医业网据路透社2002年4月5日纽约讯】研究人员报告，避免让病人暂停心跳的搭桥手术减少了术后立即出现的并发症危险。
做非体外循环搭桥手术的病人在术后第一月里出现不规则心率和胸部感染的机率比做体外循环术搭桥术的病人小，术后的住院时间也更短。“我们希望本发现能鼓励更多外科医生使用这种新方法，我们已证明它能减少并发症危险和节约医疗资源”，主要作者、英国布里斯托心脏研究所的安格利尼(Gianni D. Angelini)在一个声明中说。
传统的搭桥手术中要让病人的心脏停止跳动，在术中使用心肺机来建立血液循环。但近几年已研制出让外科医生只固定手术涉及部位的装置，在这种非体外循环的搭桥手术中，病人的心跳仍在继续。为测定新方法是否比传统方法更好，安格利尼和同事汇集了两个研究的结果，对两种方法进行了比较。研究对象有401位病人，被随机分为非体外循环和体外循环两组。
, 百拇医药
研究者在4月6日的医学杂志《柳叶刀》(The Lancet 2002;359:1194-1199)中报告，非体外循环的搭桥手术比体外循环术式多了好几项短期优点。在术后30天里，前组病人心房纤颤的机率比后组小25%，胸部感染的可能小12%，在重症监护室住1天以上及住院日超过1周的可能小13%。报告显示，平均在2年后，两组病人死亡危险相似。安格利尼和同事总结说，这证实非体外循环的搭桥手术能减少短期并发症危险，但对手术数几年后病人的健康没有什么改善。他们指出，下一步需将该手术同气囊血管成形术比较。
Heart Bypass Technique Causes Fewer Complications
Fri Apr 5,11:12 AM ET
NEW YORK (Reuters Health) - A type of bypass surgery that eliminates the need to stop a patient's heart reduces the risk of complications immediately after the surgery, researchers report.
, 百拇医药
Patients who had so-called "off-pump" bypass surgery, during which only a portion of the heart is immobilized, were less likely to experience irregular heartbeats and chest infections during the first month after surgery than patients placed on a heart-lung machine. The patients who had the off-pump surgery also were less likely to have a long stay in the hospital after surgery.
, http://www.100md.com
"We hope that our evidence will encourage more surgeons to use this new technique which we have shown can reduce complications and save hospital resources," the study's lead author, Dr. Gianni D. Angelini, of the Bristol Heart Institute in the UK, said in a statement.
Bypass surgery involves taking veins, and sometimes arteries, from other parts of the body and grafting them onto the heart to bypass a blocked vessel. During conventional bypass surgery, a person's heart is stopped and a heart-lung machine is used to circulate blood during the operation.
, 百拇医药
But in the last few years, devices have been developed that allow a surgeon to immobilize only the part of the heart affected by the surgery. During this type of "off-pump" operation, a patient's heart continues beating.
To see whether off-pump operations offer any advantages over conventional bypass surgery, Angelini and his colleagues pooled the results of two studies that compared the two techniques. The studies included a total of 401 patients who were randomly assigned to on- or off-pump surgery.
, 百拇医药
Off-pump surgery had several short-term advantages over on-pump surgery, the researchers report in the April 6th issue of the medical journal The Lancet. Within the first 30 days after surgery, off-pump patients were 25% less likely to experience an irregular heart rhythm called atrial fibrillation and 12% less likely to develop a chest infection. And they were 13% less likely to spend more than a week in the hospital or more than a day in the intensive care unit.
, http://www.100md.com
An average of about 2 years after the operation, the risk of death was similar in both groups, the report indicates. The report confirms that off-pump surgery can reduce short-term complications without compromising the health of patients a few years after surgery, Angelini and colleagues conclude.
, 百拇医药
Now off-pump bypass surgery needs to be compared with balloon angioplasty, the researchers note. This artery-clearing procedure is less expensive and causes fewer complications than conventional bypass surgery. However, because the off-pump surgery has fewer complications than traditional bypass, it should be compared directly to angioplasty in a randomized, controlled trial--the best type of trial for determining the superiority of one procedure compared with another.
Angelini designed a stabilizer used in the off-pump operations, and he receives royalties from Abbey Surgical to make the device.
SOURCE: The Lancet 2002;359:1194-1199., 百拇医药
做非体外循环搭桥手术的病人在术后第一月里出现不规则心率和胸部感染的机率比做体外循环术搭桥术的病人小，术后的住院时间也更短。“我们希望本发现能鼓励更多外科医生使用这种新方法，我们已证明它能减少并发症危险和节约医疗资源”，主要作者、英国布里斯托心脏研究所的安格利尼(Gianni D. Angelini)在一个声明中说。
传统的搭桥手术中要让病人的心脏停止跳动，在术中使用心肺机来建立血液循环。但近几年已研制出让外科医生只固定手术涉及部位的装置，在这种非体外循环的搭桥手术中，病人的心跳仍在继续。为测定新方法是否比传统方法更好，安格利尼和同事汇集了两个研究的结果，对两种方法进行了比较。研究对象有401位病人，被随机分为非体外循环和体外循环两组。
, 百拇医药
研究者在4月6日的医学杂志《柳叶刀》(The Lancet 2002;359:1194-1199)中报告，非体外循环的搭桥手术比体外循环术式多了好几项短期优点。在术后30天里，前组病人心房纤颤的机率比后组小25%，胸部感染的可能小12%，在重症监护室住1天以上及住院日超过1周的可能小13%。报告显示，平均在2年后，两组病人死亡危险相似。安格利尼和同事总结说，这证实非体外循环的搭桥手术能减少短期并发症危险，但对手术数几年后病人的健康没有什么改善。他们指出，下一步需将该手术同气囊血管成形术比较。
Heart Bypass Technique Causes Fewer Complications
Fri Apr 5,11:12 AM ET
NEW YORK (Reuters Health) - A type of bypass surgery that eliminates the need to stop a patient's heart reduces the risk of complications immediately after the surgery, researchers report.
, 百拇医药
Patients who had so-called "off-pump" bypass surgery, during which only a portion of the heart is immobilized, were less likely to experience irregular heartbeats and chest infections during the first month after surgery than patients placed on a heart-lung machine. The patients who had the off-pump surgery also were less likely to have a long stay in the hospital after surgery.
, http://www.100md.com
"We hope that our evidence will encourage more surgeons to use this new technique which we have shown can reduce complications and save hospital resources," the study's lead author, Dr. Gianni D. Angelini, of the Bristol Heart Institute in the UK, said in a statement.
Bypass surgery involves taking veins, and sometimes arteries, from other parts of the body and grafting them onto the heart to bypass a blocked vessel. During conventional bypass surgery, a person's heart is stopped and a heart-lung machine is used to circulate blood during the operation.
, 百拇医药
But in the last few years, devices have been developed that allow a surgeon to immobilize only the part of the heart affected by the surgery. During this type of "off-pump" operation, a patient's heart continues beating.
To see whether off-pump operations offer any advantages over conventional bypass surgery, Angelini and his colleagues pooled the results of two studies that compared the two techniques. The studies included a total of 401 patients who were randomly assigned to on- or off-pump surgery.
, 百拇医药
Off-pump surgery had several short-term advantages over on-pump surgery, the researchers report in the April 6th issue of the medical journal The Lancet. Within the first 30 days after surgery, off-pump patients were 25% less likely to experience an irregular heart rhythm called atrial fibrillation and 12% less likely to develop a chest infection. And they were 13% less likely to spend more than a week in the hospital or more than a day in the intensive care unit.
, http://www.100md.com
An average of about 2 years after the operation, the risk of death was similar in both groups, the report indicates. The report confirms that off-pump surgery can reduce short-term complications without compromising the health of patients a few years after surgery, Angelini and colleagues conclude.
, 百拇医药
Now off-pump bypass surgery needs to be compared with balloon angioplasty, the researchers note. This artery-clearing procedure is less expensive and causes fewer complications than conventional bypass surgery. However, because the off-pump surgery has fewer complications than traditional bypass, it should be compared directly to angioplasty in a randomized, controlled trial--the best type of trial for determining the superiority of one procedure compared with another.
Angelini designed a stabilizer used in the off-pump operations, and he receives royalties from Abbey Surgical to make the device.
SOURCE: The Lancet 2002;359:1194-1199., 百拇医药