體外循環(huán)與非體外循環(huán)冠狀動脈旁路移植術(shù)輸血情況的對比研究-展示頁
2025-01-24 01:03本頁面
【正文】 ary artery bypass(OPCAB). METHODS Three hundred and fortyfive patients underwent coronary artery bypass grafting(CABG) were divided into two groups:CCABG group (135 cases) and OPCAB group(210 cases).The transfusion of red blood cell(RBC), fresh frozen plasma(FFP),platelet and total blood volume were recorded, and its costs were calculated respectively. RESULTS The transfusion and its costs of RBC and FFP of CCABG group were significantly higher than that of OPCAB group (P),but there was no significant difference in the transfusion of platelet between the two groups(P). CONCLUSION Less transfusion of blood and plasma products is required in OPCAB than that in CCABG, which is favorable to patients and can reduce the hospitalization costs. Key words： Coronary artery bypass grafting。Transfusion 傳統(tǒng)冠脈搭橋手術(shù)(conventional coronary artery bypass grafting,CCABG)需在體外循環(huán)(extracorporeal circulation,ECC)心臟停跳下進行,血液成分在ECC過程中會受到破壞和損傷，激活的全身炎性反應(yīng)等副作用使術(shù)中或術(shù)后出血較多。本研究對比分析兩種術(shù)式下輸血情況，對臨床工作提供參考。排除標(biāo)準(zhǔn)：同期行其他心臟手術(shù)(例如瓣膜置換和大血管手術(shù)等),左室射血分數(shù)35%，術(shù)前1月內(nèi)發(fā)生過心肌梗死、神經(jīng)系統(tǒng)疾病(如腦血管事件)、嚴重的肺部疾病(肺功能檢查提示暫不宜手術(shù)者)、腎功能衰竭(術(shù)前測肌酐/尿素氮)、肝臟疾病(術(shù)前測轉(zhuǎn)氨酶/膽紅素)、活動性炎性疾病(術(shù)前測定血沉和C反應(yīng)蛋白)、有嚴重凝血性疾病及接受過抑肽酶治療等［2］。 方法 麻醉方法 采用快速誘導(dǎo)(依托米酯、舒芬太尼、哌庫溴銨、利多卡因)，靜脈復(fù)合吸入麻醉并深靜脈持續(xù)泵入丙泊酚維持,間斷給予肌松劑。OPCAB和CCABG分別在吻合結(jié)束時和停ECC后按1～∶1給予魚精蛋白靜脈滴注中和肝素，并監(jiān)測ACT恢復(fù)至正常范圍。 OPCAB 常規(guī)胸骨正中開胸,胸膜外游離乳內(nèi)動脈，兩支以上病變游離大隱靜脈或橈動脈備用。在斜竇內(nèi)縫合心包牽引線穿過紗帶拉緊抬高固定,結(jié)合Trendelenburg體位以及采用Starfish和/或Octopus IV型心臟穩(wěn)定器(sta
公司管理相關(guān)推薦
鄂ICP備17016276號-1