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体外循环对60至80岁接受冠状动脉旁路移植术患者纵隔引流及重症监护病房血液制品使用的影响。

Effects of Cardiopulmonary Bypass on Mediastinal Drainage and the Use of Blood Products in the Intensive Care Unit in 60- to 80-Year-Old Patients Who Have Undergone Coronary Artery Bypass Grafting.

作者信息

Aygün Fatih, Özülkü Mehmet, Günday Murat

机构信息

Konya Research and Medical Center, Başkent University, Turkey.

出版信息

Braz J Cardiovasc Surg. 2015 Nov-Dec;30(6):597-604. doi: 10.5935/1678-9741.20150086.

Abstract

OBJECTIVE

The present study consisted of patients who underwent on-pump coronary artery bypass grafting (CABG) and off-pump CABG and investigated effect of using cardiopulmonary bypass (CPB) on the amount of postoperative drainage and blood products, red blood cell (RBC), free frozen plasma (FFP) given in the intensive care unit in 60-80-year-old patients who underwent CABG.

METHODS

The present study comprises a total of 174 patients who have undergone coronary artery bypass graft (off-pump or on-pump CABG) surgery in our clinic in between 2012-2015 year.

RESULTS

It was observed that the amount of drainage in the first 24 postoperative hours was lower in the on-pump CABG group (Group 1) when compared to off-pump group (Group 2) (Group 1 vs . Group 2; 703.5±253.8 ml vs . 719.6±209.4 ml;P =0.716). However, the amount of drainage in the second 24 hours was statistically significantly lower in the off-pump CABG group (Group 1 vs . Group 2; 259.8±170.6 mlvs . 190.1±129.1 ml; P =0.016). With regard to the amount of overall drainage, no statistically significant difference was observed between the two groups. Group 1 needed RBC transfusion higher than Group 2 (Group 1 vs . Group 2; 2.2±1.3 bag vs . 1.2±0.9 bag;P <0.001).

CONCLUSION

We can say that CPB influences the amount of second 24-hour drainage which indexed body surface area. In addition, CPB decreases hct, hb, thrombocyte count in ICU arrived, after 24 hours in postoperative period. Reduced thrombocyte counting effect can be appeared after 48 hours in the postoperative period of CPB.

摘要

目的

本研究纳入接受体外循环冠状动脉搭桥术(CABG)和非体外循环CABG的患者,探讨在60至80岁接受CABG的患者中使用体外循环(CPB)对术后引流量及重症监护病房输注血液制品、红细胞(RBC)、新鲜冰冻血浆(FFP)量的影响。

方法

本研究共纳入2012年至2015年间在我院接受冠状动脉搭桥术(非体外循环或体外循环CABG)的174例患者。

结果

观察到,体外循环CABG组(第1组)术后首24小时引流量低于非体外循环组(第2组)(第1组 vs. 第2组;703.5±253.8 ml vs. 719.6±209.4 ml;P =0.716)。然而,非体外循环CABG组术后次24小时引流量在统计学上显著更低(第1组 vs. 第2组;259.8±170.6 ml vs. 190.1±129.1 ml;P =0.016)。关于总引流量,两组间未观察到统计学显著差异。第1组比第2组需要更多的RBC输血(第1组 vs. 第2组;2.2±1.3袋 vs. 1.2±0.9袋;P <0.001)。

结论

我们可以说CPB影响以体表面积为指标的次24小时引流量。此外,CPB会降低术后24小时后进入重症监护病房时的血细胞比容、血红蛋白、血小板计数。CPB术后48小时可能出现血小板计数降低效应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e68/4762549/fca87d4f6a47/rbccv-30-06-0597-g01.jpg

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