心脏手术术后大出血及再开胸——一个简单而值得思考的主题  

Excessive bleeding and reexploration after cardiac surgery is a simple and worth thinking about issue

作　　者：钱永军[1] 余惠[1] 梁伟涛 李涛[1] 肖锡俊[1] QIAN Yongjun;YU Hui;LIANG Weitao;LI Tao;XIAO Xijun(Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China)

机构地区：[1]四川大学华西医院心脏大血管外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2018年第5期368-371,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家"十三五"重点研发专项资助(2016YFC1302003);四川省科技计划重点研发项目(2017SZ0056);四川省卫生和计划生育委员会科研课题(17PJ177)

摘　　要：心脏手术术后大出血的发生率及再开胸发生率都比较高,并将会带来一系列严重并发症,如额外增加一次手术、延长监护室停留时间、延长机械通气时间、增加异体血液制品注入量及增加死亡率等。尽管如此,国内对心脏手术术后大出血的认识与国际差别仍较大,心脏外科临床工作中对心脏手术术后大出血及再开胸的问题认识仍不够。本文将在心脏术后大出血及再开胸方面存在的问题如大出血常见相关因素分析,止血流程的优化及再开胸的危害等方面进行阐述。The incidence of postoperative excessive bleeding and reexploration is relatively high, and it will bring a series of serious complications, such as an additional surgery, a longer intensive care unit stay, longer time on mechanical ventilation, an increase need of allogeneic blood product transfusions and increased mortality. However, the understanding of postoperative excessive bleeding and reexploration in China is significantly different from the international level, and the understanding of postoperative excessive bleeding and reexploration after cardiac surgery in clinical work is still not enough. This review will focus on some problems, such as related factors analysis of postoperative excessive bleeding, hemostatic process optimization and the serious complications of reexploration after cardiac surgery.

关 键 词：大出血 再开胸 心脏手术 

分 类 号：R654.2[医药卫生—外科学]