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冠状动脉旁路移植术的研究进展
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Abstract:
冠状动脉旁路移植术(CABG)作为治疗冠心病的重要手术方式，近年来在技术上取得了显著进展。传统CABG虽能有效改善患者血流，但也面临着手术创伤大、术后恢复时间长等局限性。这就促使了微创技术的发展。随着对手术创伤的深入认识，微创技术(如MIDCAB和RACAB)以及杂交手术(HCR)应运而生，通过减少皮肤切口长度和整合外科与介入技术，显著降低了患者的术后疼痛和恢复时间。在这个基础上，非体外循环CABG (OPCABG)进一步减少了手术并发症，尤其适用于高风险患者。另外，动脉移植物(如LIMA和RA)也因其高长期通畅率成为首选。同时术中影像技术和血流评估的引入进一步优化了手术效果。研究表明，与单纯药物治疗相比，不断迭代的精细化和个性化的CABG术式显著改善了患者的长期生存率和生活质量。在未来，人工智能、生物工程和精准医学的深度融合将推动CABG向更个性化、精准化的方向发展，为患者提供更优质的治疗效果。
Coronary artery bypass grafting (CABG) as an important surgical method for treating coronary heart disease has made significant progress in technology in recent years. Traditional CABG can effectively improve patient blood flow, but it also faces limitations such as large surgical trauma and long postoperative recovery time. This has driven the development of minimally invasive technology. With a deeper understanding of surgical trauma, minimally invasive technologies (such as MIDCAB and RACAB) and hybrid surgery (HCR) have emerged, significantly reducing patient postoperative pain and recovery time by reducing skin incision length and integrating surgery with interventional technology. On this basis, off-pump coronary artery bypass grafting (OPCABG) further reduces surgical complications, especially suitable for high-risk patients. Additionally, arterial grafts (such as LIMA and RA) have become the first choice due to their high long-term patency rate. The introduction of intraoperative imaging technology and blood flow assessment has further optimized surgical outcomes. Studies have shown that compared to simple drug treatment, the constantly evolving and personalized CABG surgery has significantly improved patients’ long-term survival rate and quality of life. In the future, the deep integration of artificial intelligence, bioengineering, and precision medicine will drive CABG towards more personalized and precise development, providing patients with better treatment outcomes.
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