自体富血小板血浆回输在迷宫Ⅲ型手术中的应用  

Application of autologous platelet-rich plasma on patients undergoing Cox MazeⅢprocedure

作　　者：肖雄 刘涛 韩劲松 尹宗涛 刘宇 Xiao Xiong;Liu Tao;Han Jinsong;Yin Zongtao;Liu Yu(Department of Cardiovascular Surgery,General Hospital of Northen Theater Command,Shenyang 110016,China)

机构地区：[1]中国人民解放军北部战区总医院心血管外科,沈阳110016

出　　处：《中国体外循环杂志》2020年第5期289-291,共3页Chinese Journal of Extracorporeal Circulation

摘　　要：目的探讨应用自体富血小板血浆回输技术对迷宫Ⅲ型手术的影响。方法回顾性分析2013年5月至2017年10月在本科接受迷宫Ⅲ型手术治疗瓣膜病合并心房颤动患者122例。根据是否应用自体富血小板血浆回输技术分为试验组(n=52)和对照组(n=70)。试验组体外循环开始前保存富血小板血浆,在鱼精蛋白中和肝素后再回输给患者。记录患者围术期资料及输血情况。结果试验组患者术后24 h引流量明显低于对照组(469±214)ml vs.(547±192)ml(P=0.037),试验组患者围术期输血比例明显少于对照组(30.8%vs.48.6%,P=0.049);两组患者在主动脉阻断时间、体外循环时间、呼吸机辅助时间、监护室停留时间及围术期并发症发生率差异无统计学意义(P>0.05)。结论自体富血小板血浆回输可以减少迷宫Ⅲ型手术患者术后引流量,降低对同种异体血的输注需求,是一种较安全、有效的血液保护方法。Objective To evaluate the effect of autologous platelet-rich plasma(aPRP)on patients undergoing cox mazeⅢproduce.Methods A total of 122 patients who underwent Cox mazeⅢprodecure for atrial fibrillation with valvular heart disease in our center from May 2013 to October 2017 were retrospectively analyzed.According to whether received aPRP or not,they were divided into aPRP group(n=52)and non-aPRP group(n=70).The aPRP was preserved before cardiopulmonary bypass(CPB)and trans⁃fused to patients after the reversal of heparin by protamine in aPRP group.Perioperative transfusion requirements and clinical outcomes were collected for further analysis.Results The aPRP group was associated with a reduction in postoperative blood loss(469±214 vs.547±192,P=0.037)as well as a decrease in the rate of perioperative allogeneic transfusion(30.8%vs.48.6,P=0.049)compared with non-aPRP group.There were no significant difference in aortic cross-clamping time,CPB time,ventilation time,length of stay in intensive care unit and the incidence of perioperative complications between the two groups(P>0.05).Conclusion Autologous platelet-rich plasma transfusion could reduce postoperative blood loss as well as perioperative allogeneic transfusion for patients who un⁃derwent cox mazeⅢprocedure,and it was was a safe and effective blood conservation technique.

关 键 词：自体富血小板血浆 迷宫手术 体外循环 血液回输技术 出血 血液保护 

分 类 号：R457.1[医药卫生—治疗学] R654.2[医药卫生—临床医学]