Sasaki Y, Shibata T, Hirai H, Motoki M, Bito Y, Takahashi Y, Suehiro S
Department of Cardiovascular Surgery, Osaka City University Medical School, Osaka, Japan.
Kyobu Geka. 2006 May;59(5):355-8.
We report a 61-year-old man with aplastic anemia who underwent successful off-pump coronary artery bypass (OPCAB) after being admitted for angina pectoris. Coronary angiography showed severe stenosis of the left main coronary artery. Preoperative WBC was 2,200/microl, neutrophil 704/microl, Hb 8.1g/dl, and PLT 16,000/microl. We conducted OPCAB on double vessels using left internal thoracic and radial artery grafts. Thirty units of platelets were transfused intraoperatively with little perioperaive hemorrhage. Because of high grade fever, we injected 150 microg granulocyte colony-stimulating factor (G-CSF) every 3 days postoperatively to prevent major infection. The combination of appropriate perioperative management and OPCAB yielded an effective result for a patient with severe hematological disorders causing pancytopenia.
我们报告一例61岁再生障碍性贫血男性患者，因心绞痛入院后成功接受了非体外循环冠状动脉搭桥术（OPCAB）。冠状动脉造影显示左主干冠状动脉严重狭窄。术前白细胞计数为2200/微升，中性粒细胞704/微升，血红蛋白8.1克/分升，血小板16000/微升。我们使用左胸廓内动脉和桡动脉移植物对双支血管进行了OPCAB。术中输注了30单位血小板，围手术期出血很少。由于高热，我们在术后每3天注射150微克粒细胞集落刺激因子（G-CSF）以预防严重感染。适当的围手术期管理与OPCAB相结合，对一名因严重血液系统疾病导致全血细胞减少的患者产生了有效的治疗效果。
