血栓弹力图指导下输血及监测肝素是否残留对心外术后心功能的影响  

Effect of thrombelastogram-guided blood transfusion and monitoring of heparin residual on cardiac function after heart surgery

作　　者：孟凯 李晓亚 王安祥 Meng Kai;Li Xiao-ya;Wang An-xiang(Department of Critical Care Medicine,Huainan Chaoyang Hospital,Huainan 232000,China)

机构地区：[1]淮南朝阳医院重症医学科,淮南232000

出　　处：《湖南师范大学学报（医学版）》2022年第1期262-265,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:探讨血栓弹力图指导下输血及监测肝素是否残留对心外术后心功能的影响。方法:通过整群抽样法,回顾性分析我院2016年6月~2019年10月期间收治的60例行心脏外科手术患者的临床资料,将其中采取常规凝血功能监测指导输血的35例患者纳入A组,以及采用血栓弹力图监测下指导输血的25例患者纳入B组。对比两组患者术后心功能、凝血功能、血红蛋白水平、手术及短期转归相关指标。结果:术后两组心功能改善情况、体外循环、手术、气管插管及ICU住院时间及引流量相比,差异无统计学意义。相比A组,B组PT、APTT均较短,血红蛋白及红细胞比容水平均较高,差异均有统计学意义。结论:心外术后采用血栓弹力图监测指导输血,能够有效改善心功能,保护凝血功能,且利于血制品的合理使用。Objective To investigate the effect of thrombelastogram-guided blood transfusion and monitoring of heparin residual on cardiac function after heart surgery.Methods The cluster sampling method was adopted,and the clinical data of 60 patients with heart surgery in the hospital from June 2016 to October 2019 were retrospectively analyzed.35 patients with blood transfusion guided by routine coagulation function monitoring were included in A group,and 25 patients with blood transfusion guided by thrombelastogram were included in B group.The postoperative cardiac function,coagulation function,hemoglobin,surgical and short-term outcome indexes were compared between two groups.Results After surgery,there was no statistical difference in the improvement of cardiac function,cardiopulmonary bypass,operation time,tracheal intubation time,ICU hospital stays and drainage volume between two groups;Compared with A group,the PT and APTT of B group were shorter,and the hemoglobin and hematocrit value in B group were higher.Conclusion The monitoring of thrombelastogram in guiding blood transfusion after heart surgery can effectively improve cardiac function,protect coagulation function,and facilitate the rational use of blood products.

关 键 词：心外手术 血栓弹力图 输血 监测肝素 心功能 

分 类 号：R654.2[医药卫生—外科学]