原发性血小板增多症患者行冠状动脉旁路移植术:病例报道和文献回顾  

Coronary Artery Bypass Grafting in Patients with Essential Thrombocythemia:A Case Report and Literature Review

作　　者：赵媛媛 杨秋红[2] 潘世伟[3] 何丽仙 邵恳 姚允泰[1] ZHAO Yuan-yuan;YANG Qiu-hong;PAN Shi-wei;HE Li-xian;SHAO Ken;YAO Yun-tai(Department of Anesthesiology,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100037,China;Department of Anesthesiology,Ningbo First People's Hospital,Ningbo 315010,Zhejiang,China;Department of Adult Surgery,Fuwai Hospital,National Center for Cardiovascular Disease,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100037,China;Department of Anesthesiology,Jingmen First People's Hospital,Jingmen 448000,Hubei,China)

机构地区：[1]中国医学科学院,北京协和医学院,国家心血管病中心,阜外医院麻醉科,北京市100037 [2]宁波市第一医院麻醉科,宁波市315010 [3]中国医学科学院,北京协和医学院,国家心血管病中心阜外医院成人外科,北京市100037 [4]荆门市第一人民医院麻醉科,荆门市448000

出　　处：《中国分子心脏病学杂志》2021年第1期3719-3724,共6页Molecular Cardiology of China

摘　　要：目的总结现有文献,为原发性血小板增多症(essential thrombocythemia,ET)患者行冠状动脉旁路移植术(coronary artery bypass grafting,CABG)提供经验。方法结合本院ET病例检索中国知网、万方数据、维普网、中国生物医学网及PubMed等数据库,下载有关ET患者行CABG的个案报道,提取信息并总结经验。结果共纳入15篇相关文献,其中男性19例,女性6例。CABG 21例,主动脉瓣置换术(aortic valve replacement,AVR)+CABG 4例。5例患者术后发生严重并发症,其中4例术前血小板计数(blood platelet count,BPC)≥800×10^(9)/L,1例术后植入左心室辅助装置(left ventricular assist device,LVAD)、心脏移植,1例因室颤、心脏停搏死亡。结论ET患者行CABG时易发生血栓或/和出血并发症,围手术期处理应包括降血小板治疗、预防血栓及心肌血运重建。Objective To summarize the available literature and provide experience for patients with essential thrombocythemia(ET)undergoing coronary artery bypass grafting(CABG).Methods Combined with an ET case in our hospital,a systematic literature search was conducted in the databases such as CNKI,Wanfang Data,CQVIP,SinoMed and PUBMED to retrieve relevant documents and extract information.Results A total of 25 patients in 15 relevant case reports were ultimately enrolled,including 19 males and 6 females.CABG in 21 cases,aortic valve replacement(AVR)+CABG in 4 cases.Severe postoperative complications occurred in 5 patients,of which 4 of 5 had an immediate preoperative PLT count of 800×10^(9)/L or higher.Left ventricular assisted device was implanted and heart transplantation was performed in 1 case.One case died of ventricular fibrillation and cardiac arrest,Conclusion ET patients undergoing CABG are at risk of perioperative thrombosis or bleeding or both.Perioperative management should include antiplatelet therapy,prophylaxis of thrombus and myocardial revascularization.

关 键 词：原发性血小板增多症 冠状动脉旁路移植术 病例报道 回顾性分析 

分 类 号：R654.2[医药卫生—外科学]