关键词: 急性心肌梗死, 冠状动脉旁路移植术, 死亡率

Abstract: Objective To compare analysis of different operation timing of coronary artery bypass grafting (CABG) for acute ST segment elevation myocardial infarction (STEMI). Method We retrospectively analyzed the clinical data and results of 206 patients who underwent CABG from January 2009 to December 2017 in Qingdao Municipal Hospital.There were 30 emergency/urgent surgeries (group A).Stable STEMI patients who underwent CABG after acute myocardial infarction 1 week within 30 days had 66 cases (group B).Randomly selected 110 patients with non-myocardial infarction undergoing elective CABG in the same period(group C).Comparing the general clinical data,surgical methods,coronary artery lesions,transplantation materials,postoperative complications,perioperative mortality,time of ICU stay,and IABP application of the three groups of patients.To follow these patients in cardiac surgery clinic or by telephone,and recording the time from discharge to the last follow-up and general clinical data. Result There was no statistically significant difference in the number of transplanted blood vessels and materials among the three groups.There was a statistically significant difference between group A and group B or between group A and group C in mortality,postoperative complications (low cardiac output,multiple organ failure,arrhythmia) and the use of IABP (P<0.05).The difference between group B and group C was no significant (P>0.05).Significant differences among three groups(A、B、C) at ICU time.A total of 183 patients were followed up by a follow-up rate of 88.8% with a period ranged from 10 to 26 months (20.7±3.12 months).One patient died of cerebrovascular accident in group A,one patient died of a traffic accident in Group C and there was no death in group B during follow-up. Conclusion CABG is safe for stable STEMI patients after 7 days of myocardial infarction within 30days with full preoperative preparation and can improve the patients survival.The patients with cardiogenic shock,persistent myocardial ischemia and mechanical concurrency should receive the emergency CABG to save lives.

Key words: acute myocardiaI infarction, coronary artery bypass grafting, mortality