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目的探讨选择性冠状静脉搭桥治疗冠状动脉性心脏病的临床价值。方法冠状动脉性心脏病患者16例,均为弥漫性冠状动脉病变远端通畅不良或管腔闭塞无法施行冠状动脉搭桥术者,而行非体外循环下选择性冠状静脉搭桥。观察治疗前后心绞痛情况、心电图ST改变、超声心动图指标及单光子发射计算机断层显像(SPECT)检查心肌灌注显像检查情况。结果 16例患者手术后ST段的恢复率96.88%(15/16),心绞痛分级好转率为100%(16/16),相应节段心肌核素放射性分布改善率100%(16/16),室壁运动术后第10天的好转率为50%(8/16),术后3个月好转率为87.5%(14/16)。结论 选择性冠状静脉搭桥能改善相应节段心肌的血流灌注和室壁运动。
Objective To investigate the clinical value of selective coronary vein bypass in the treatment of coronary heart disease. Methods Sixteen patients with coronary heart disease (CAD), all of whom had diffuse coronary artery disease with distal patency or lumen occlusion, were excluded from coronary artery bypass grafting. They underwent selective coronary venous bypass without cardiopulmonary bypass. Before and after treatment, angina pectoris, ECG ST changes, echocardiographic parameters and single photon emission computed tomography (SPECT) examination myocardial perfusion imaging examination. Results The recovery rate of ST segment after operation in 96 patients was 96.88% (15/16), the improvement rate of angina pectoris grade was 100% (16/16), the corresponding segments of myocardial radionuclide distribution improvement rate was 100% (16/16) The improvement rate was 50% (8/16) on the 10th postoperative wall motion and 87.5% (14/16) at 3 months postoperatively. Conclusion Selective coronary venous bypass can improve perfusion and wall motion in the corresponding segmental myocardium.