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目的 评价同期颈动脉内膜剥脱术(CEA)和冠状动脉旁路移植术(CABG)治疗合并无症状重度颈动脉狭窄的冠心病患者的早期预后以及体外循环对患者预后的影响.方法 本研究包括中国阜外医院于2005年1月-2015年1月接受同期单侧CEA和CABG的69名合并无症状重度颈动脉狭窄的冠心病患者.69名患者根据CABG是否应用体外循环被分为2组:体外循环组(n=36)和非体外循环组(n=33).患者主要的心脑血管不良事件和死亡的发生率被研究.结果 体外循环组患者术后脑卒中、TIA、谵妄、Q波性心肌梗死、心脏停搏的心脑血管不良事件(MACCE)和死亡的发生率分别为16.67％和2.78％,非体外循环组患者术后MACCE和死亡的发生率均为3.03％,2组患者间术后MACCE事件和死亡的发生率差异无统计学意义(P＞0.05).与体外循环组比较,非体外循环组术后ICU停留时间和住院时间缩短,差异有统计学意义(p＜0.05).结论 同期CEA和CABG对于冠心病合并重度无症状颈动脉狭窄患者的近期疗效满意.CEA后全麻下CABG较体外循环下CABG显著缩短患者术后的ICU停留时间和住院时间.“,”Objective To evaluate the early results of simultaneous carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) in patients with asymptomatic severe carotid artery stenosis and coronary heart disease and the effects of cardiopulmonary bypass on outcomes.Methods An observational study was performed on 69 patients with asymptomatic severe carotid artery stenosis and coronary heart disease receiving simultaneous CEA and CABG in Fuwai hospital during January,2005 to January,2015.They were divided into two group:On-pump group and Off-pump group (n =36,33).The patient,s major adverse cerebral and cardiovascular events and death were studied.Results The incidence of MACCE in On-pump group was 16.67％ and in Off-pump group was 3.03％.There were 1 death(2.78％) in On-pump group and 1 death(3.03％) in Off-pump group.There were no significant differences in the incidence of MACCE and death between the two groups(p＞0.05).Compared with On-pump group,the patients in Off-pump group were associated with significant decreased post-operative ICU stay and hospital stay(P＜0.05).Conclusions The early outcome of simultaneous CEA and CABG to the patients with asymptomatic severe carotid artery stenosis and coronary heart disease is satisfactory.The patients received simultaneous CEA and off-pump CABG are associated with significant decreased post-operative ICU stay and hospital stay.