氨甲环酸联合自体血回输在非体外循环冠脉搭桥术中的应用

发布时间：2018-08-31 09:32

【摘要】：目的观察氨甲环酸联合自体血回输技术对非体外循环冠脉搭桥术(OPCAB)患者术后出血量及异体血输血量的影响。方法回顾分析择期行OPCAB的146例患者资料,纳入患者年龄不限,分为对照组(A组,51例),氨甲环酸组(B组,30例)和氨甲环酸联合自体血回输组(C组,65例)。比较3组OPCAB患者血常规中的Hb、Hct、Plt的变化、失血量和输血情况。结果 3组患者术前Hb、Hct、Plt组间比较差异无统计学意义;术后Hb、Hct、Plt与术前比较降低(P0.05),但仍维持在正常范围。与A组(500±249)m L相比,B组心包纵膈引流量(404±150)m L和C组(405±186)m L心包纵膈引流量均减少(P0.05)。3组患者的异体输血发生率分别为:A组78.43%(40/51);B组46.67%(14/30);C组16.92%(11/65),组间比较差异有统计学意义(P0.0125)。与A组(871±422)m L相比,B组(600±272)m L和C组(323±130)m L患者的异体血输入量减少(P0.05),并且C组患者异体输血量较B组患者少(P0.05)。3组患者术前PT、APTT、INR、FIB等指标差异无统计学意义(P0.05),3组患者术后PT、APTT、INR、FIB等指标与术前比较差异无统计学意义(P0.05)。结论使用氨甲环酸联合自体血回输技术可以安全有效地减少OPCAB患者术后出血量以及异体血输血量。
[Abstract]:Objective to observe the effect of carbamate combined with autologous blood transfusion on blood loss and allogeneic blood transfusion after off-pump coronary artery bypass grafting (OPCAB). Methods the data of 146 patients with OPCAB were retrospectively analyzed. The patients were divided into three groups: control group (group A, n = 51), group B (n = 30) and group C (n = 65). The changes of Hb,Hct,Plt, blood loss and blood transfusion in three groups of OPCAB patients were compared. Results there was no significant difference in preoperative Hb,Hct,Plt among the three groups, but Hb,Hct,Plt was decreased after operation (P0.05), but remained in the normal range. Compared with group A (500 卤249) m L), the incidence of allogeneic blood transfusion in group B (404 卤150) m L) and group C (405 卤186) m L) was 78.43% (40 / 51) in group B and 16.92% (11 / 65) in group C, respectively (P0.0125). Compared with group A (871 卤422) m L), group B (600 卤272) m L) and group C (323 卤130) m L) decreased the volume of allogeneic blood transfusion (P0.05), and the volume of allogeneic blood transfusion in group C was less than that in group B (P0.05). There was no significant difference in preoperative PT,APTT,INR,FIB and other indexes between group B and group B (P0.05). There was no significant difference between the two groups (P0.05). Conclusion it is safe and effective to reduce postoperative blood loss and allogeneic blood transfusion in patients with OPCAB by using the combination of carbamicylic acid and autologous blood transfusion.
【作者单位】：宁夏医科大学;宁夏医科大学总医院麻醉科;
【分类号】：R654.2

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