冠状动脉旁路移植术中低温与液体保存血小板的比较  

Comparison of transfusion of cryopreserved platelet and liquid preserved platelet in CABG

作　　者：马曙轩[1] 白丽霞[1] 刘景汉[1] 欧阳锡林1 李锡金[1] 白丽娟[2] 肖苍松[3] 

机构地区：[1]解放军总医院输血科,北京100853 [2]山西省军区门诊部 [3]解放军总医院心血管外科

出　　处：《山西医科大学学报》2004年第4期354-356,共3页Journal of Shanxi Medical University

基　　金：国家自然科学基金资助项目 ( 3 0 2 714 43 )

摘　　要：目的　比较研究低温保存血小板及液体保存血小板在冠状动脉旁路移植术 (CABG)中的止血效果。方法　选取我院接受CABG患者 6 0例 ,按照患者性别相同、年龄相近 (± 1岁以内 ) ,冠状动脉病变侧支数目相同的条件进行配对分为 2组。Ⅰ组输注去白细胞红细胞、低温保存的血小板 ;Ⅱ组输注去白细胞红细胞、液体保存的血小板。分别统计患者平均输血量、手术后 2 4h引流量作为衡量两种方法保存血小板止血作用的 2个指标。结果　Ⅰ组 30例患者平均输去白细胞红细胞 30 9.15ml ,输低温保存血小板 30 4 .18ml,共计输血 6 13.33ml。Ⅱ组 30例患者平均输去白细胞红细胞 4 36 .5 0ml ,输液体保存血小板 314 .17ml,共计输血 75 0 .6 7ml。经t检验 ,两组输血总量差异有显著性。两组患者手术后 2 4h平均引流分别为 388ml和4 5 4ml,经t检验 ,两者差异具有显著性。结论　在冠状动脉旁路移植术中输注低温保存血小板可以降低患者输注异体血的量 ,减少手术后引流量 ,从而间接反映了低温保存血小板的止血效果较液体保存血小板更好。Objective To compare the hemostatic effect of cryopreserved platelet and liquid preserved platelet in patients undergoing cardiopulmonary artery bypass grafting (CABG). Methods Sixty in-patients were designed into two groups(groups 1and 2, each n=30 ), according to identical sex, similar age (±1 year)and the same state of illness in cardiopulmonary artery. Patients in group 1 received transfusion of leucocyte reduction red blood cell(LR-RBC) and cryopreserved platelet(CP), while patients in group 2 received transfusion of LR-RBC andliquid preserved platelet(LPP). The hemostatic effect was evaluated by the average blood transfusion amount, and the amount of ooze fluid in 24 h after operation. Results The average blood transfusion amount was 613.33 ml(composed of 309.15 ml LR-RBC and 304.18 ml CP) and 751.67 ml(composed of 436.50 ml LR-RBC and 314.17 ml LPP) in groups 1 and 2 respectively. Two groups were compared. There was significant difference between both. The average amount of ooze fluid in 24 h after operation in groups 1 and 2 was 388 ml and 454 ml respectively. Conclusion Cryopreserved platelet is superior to liquid preserved platelet in reducing blood loss and need for homologous blood product transfusion inCABG, suggesting that cryopreserved platelet has better hemostatic effect thanliquid preserved platelet.

关 键 词：血小板保存法 二甲亚砜 冠状动脉分流术 输血 止血 

分 类 号：R457[医药卫生—治疗学]