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目的:观察药物洗脱支架(DES)和冠状动脉旁路移植术(CABG)对冠状动脉多支病变的疗效。方法:220例多支病变冠心病(CHD)患者接受DES(148例)或CABG(72例),观察围术期疗效、并发症,进行临床随访了解远期疗效(再发心绞痛、再次血运重建、死亡、无事件存活等)。结果:围手术期DES和CABG的手术成功率均较高,两组间差异无统计学意义(P>0.05)。心力衰竭发生率CABG组高于DES组,差异有统计学意义(P<0.05);死亡、脑梗塞、心绞痛、多脏器功能衰竭发生率两组间无明显差异(P>0.05)。术后(12±6.7)个月随访结果示:DES组的再发心绞痛、靶血管重建高于CABG组,差异有统计学意义(P<0.05)。非致死性心肌梗死、新发心力衰竭、脑血管病、心脏性死亡、无事件存活率等两组间差异无统计学意义(P>0.05)。结论:CHD多支冠状动脉病变患者,CABG和DES的手术成功率均较高,近期疗效无明显区别。远期疗效观察,两组死亡率无明显区别,但CABG组的再发心绞痛及靶血管重建小于DES组。
Objective: To observe the effect of drug-eluting stent (DES) and coronary artery bypass graft (CABG) on coronary artery disease. Methods: A total of 220 patients with coronary artery disease (CHD) with multi - branch disease underwent DES (148 cases) or CABG (72 cases). The perioperative efficacy and complications were observed and followed up for long - term follow - up (recurrent angina, Reconstruction, death, event-free survival, etc.). Results: Surgical success rate of perioperative DES and CABG was high, with no significant difference between the two groups (P> 0.05). The incidence of heart failure was higher in the CABG group than in the DES group (P <0.05). There was no significant difference in the incidence of death, cerebral infarction, angina and multiple organ failure between the two groups (P> 0.05). The follow-up results at 12 ± 6.7 months postoperatively showed that the recurrence of angina and target vessel reconstruction in DES group was higher than that in CABG group (P <0.05). There was no significant difference between the two groups in non-fatal myocardial infarction, new-onset heart failure, cerebrovascular disease, cardiac death and event-free survival (P> 0.05). Conclusion: The success rate of CABG and DES in CHD patients with multiple coronary artery disease is high, and there is no significant difference in the short term efficacy. Long-term efficacy, no significant difference between the two groups of mortality, but the CABG group of recurrent angina and target vessel reconstruction less than the DES group.