非体外循环冠状动脉旁路移植术患者血液流变学变化  

The changes of hemorrheology at off-pump coronary artery bypass grafting patients

作　　者：阎兴治[1] 李正伦[1] 黄方炯[2] 孙照林[1] 杨世虞[1] 张大国[1] 向道康[1] 

机构地区：[1]贵州省人民医院心外科,贵阳550002 [2]首都医科大学附属安贞医院心外科

出　　处：《贵州医药》2002年第5期403-404,共2页Guizhou Medical Journal

基　　金：贵州省优秀科技人才省长专项基金资助项目 (2 0 0 1年第 4号 )

摘　　要：目的对比观察体外循环与非体外循环冠状动脉旁路移植术 (CABG)患者血液流变学的变化 ,探索二者对组织器官的损害及在减少术后并发症和节省住院费用等方面的优越性。方法 17例CABG患者随机分为两组 :非体外循环组 (实验组 ) 8例 ,手术在常温心脏跳动下进行 ;体外循环组(对照组 ) 9例 ,术中阻断升主动脉 ,鼻咽温度为 2 5℃～ 2 7℃。动态监测围术期所有患者全血粘度(CP)、红细胞压积 (HCT)、红细胞聚集指数 (RCI)、血小板聚集率 (PCR)的变化。结果两组患者术前上述参数组间比较差异无显著意义 (P >0 0 5 ) ;术中及术后 8小时 ,两组参数组间比较差异具显著意义(P <0 0 5 ) ,且均低于术前 (P <0 0 5或P <0 0 1) ;术后 1天上述参数均恢复至术前水平。结论非体外循环CABG由于术中不应用体外循环 ,避免了因血液稀释和血液成分破坏引起的血液流变学变化对组织器官的损害 。Objective To investigate the changes of hemorrheology at off pump coronary artery bypass grafting (CABG) patients.Methods 17 CABG patients were divided into off pump group( n =8) and on pump group( n =9),The parameters of hemorrheology were measured dynamicly during the perioperative period.Results The parameters of hemorrheology in off pump group were significantly higher during operation and on 8h postoperation than those in on pump group( P <0.05 or P <0 01),and its were significantly lower during operation and on 8h postoperation in both groups than its were operation before( P <0 05 or P <0 01)?Conclusion Because it was reduced blood dilution and avoided nonphysiological circulatory of the cardiopulmonary bypass to the body,off pump coronary artery bypass grafting may be reduced the morbidity of complications and blood transfusion.

关 键 词：冠状动脉旁路移植术 体外循环 血液流变学 

分 类 号：R654.2[医药卫生—外科学]