Hamid Mohammad, Akhtar Mohammad Irfan, Naqvi Hamid Iqil, Ahsan Khalid
Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan.
J Pak Med Assoc. 2017 Jul;67(7):1019-1023.
To observe the incidence and pattern of thrombocytopenia in cardiac surgery patients.
This prospective, cohort study was conducted at the Aga Khan University Hospital, Karachi, from November 2014 to April 2015, and comprised adult cardiac patients. Patients with platelet count less than 150,000 x 109/L, history of malignancy, immune thrombocytopenic purpura and on chemo or radiotherapy were excluded. All information including demographics, platelet count, heparin doses, total cardiopulmonary bypass time, cross-clamp time, blood products transfused, any thromboembolic complication and the presence of infection were recorded on a pre-designed proforma. SPSS 19 was used for data analysis..
Of the 177 patients, 130(73.4%) were males and 47(26.6%) were females. The overall mean age was 59.21±10.99 years. Thrombocytopenia was observed in 167(94.4%) patients. Of them, platelet count dropped below 50% in 71(42.5%) patients, 30-50% in 68(40.7%) patients and 20-30% in 28(16.8%) from the baseline value. Regarding pattern of thrombocytopenia, maximum drop in platelet count was noticed on 2nd and 3rd day of surgery. Furthermore, 9(5.3%) patients developed severe thrombocytopenia (<50,000 x 109/L).
The incidence of thrombocytopenia and its severity after cardiac surgery was very high in our study population when compared with western population.
观察心脏手术患者血小板减少症的发生率及类型。
本前瞻性队列研究于2014年11月至2015年4月在卡拉奇的阿迦汗大学医院进行，纳入成年心脏手术患者。排除血小板计数低于150,000×10⁹/L、有恶性肿瘤病史、免疫性血小板减少性紫癜以及正在接受化疗或放疗的患者。所有信息，包括人口统计学资料、血小板计数、肝素剂量、体外循环总时间、主动脉阻断时间、输注的血液制品、任何血栓栓塞并发症以及感染情况，均记录在预先设计的表格中。使用SPSS 19进行数据分析。
177例患者中，男性130例（73.4%），女性47例（26.6%）。总体平均年龄为59.21±10.99岁。167例（94.4%）患者出现血小板减少症。其中，71例（42.5%）患者血小板计数降至基线值的50%以下，68例（40.7%）患者降至30 - 50%，28例（16.8%）患者降至20 - 30%。关于血小板减少症的类型，手术第2天和第3天血小板计数下降最为明显。此外，9例（5.3%）患者出现严重血小板减少症（<50,000×10⁹/L）。
与西方人群相比，我们研究人群中心脏手术后血小板减少症的发生率及其严重程度非常高。
