摘要目的 探讨在冠脉搭桥手术中,使用双侧乳内动脉和单侧乳内动脉对胸骨愈合的影响.方法 冠脉搭桥患者按照随机数字表法分为实验组(双侧乳内动脉搭桥组)和对照组(单侧乳内动脉搭桥组).实验组50例,男37例,女13例,对照组50例,男34例,女16例.观察各组的胸骨愈合情况以及术后并发症.结果 实验组中患者术后引流量以及胸骨愈合不良的发生率[第1天引流量:(350.67±56.86) ml vs(240.72±48.35) ml;总引流量:(595.65± 102.35) ml vs(398.85±75.84) ml;胸骨愈合不良的发生率:20％ vs 0;P＜0.05或P＜0.01]明显高于对照组中的患者.具有三项以上的胸骨愈合不良危险因素的患者,实验组与对照组比较胸骨愈合不良的发生率差异有统计学意义(8例vs 0例,P ＜0.05).结论 与单侧乳内动脉搭桥患者相比,双侧乳内动脉搭桥增加了患者胸骨愈合不良的风险.

abstractsObjective To investigate the effect of double versus single internal thoracic artery on sterna wound healing in coronary artery bypass grafting (CABG).Methods Patients undergoing CABG were randomly divided into experimental group (double internal thoracic artery group) and control group (single internal thoracic artery group) according to the number of internal thoracic artery used in operations.Experimental group:skeletonized double internal mammary arteries were harvested in all 50 cases (37 males and 13 females).Control group:skeletonized left internal mammary artery was harvested in all 50 cases (34 males and 16 females).Sterna wound healing and post-operational complications were observed.Results The incidence of poor sterna wound healing and volume of drainage after operation in the experimental group were more than those in the control group [volume of drainage on the first day:(350.67±56.86)ml vs (240.72 ±48.35)ml;total volume of drainage:(595.65 ± 102.35) ml vs (398.85 ± 75.84) ml;poor sterna wound healing rate:20％ vs 0;P ＜ 0.05 or P ＜ 0.01].The sterna wound healing rate of high-risk patients between two groups had significant difference (8 cases vs 0 case,P ＜ 0.05).Conclusions Compared to the single internal mammary artery grafting,the double internal mammary artery grafting increased the risk of sternal wound healing.