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在心肺绕道术后,手术内救血与凝血障碍之间的关联
Masahiro Morinaga1, Kenji Yoshitani2, Soshiro Ogata3
1Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
JA clinical reports
|January 25, 2024
概括
在心肺绕道术后,手术内挽救血液并没有增加凝血障碍的风险. 这一发现在常规测试和血栓形成显微镜中是一致的,表明接受心脏手术的患者的安全性.
科学领域:
- 心血管外科心血管外科
- 麻醉学 麻醉学
- 血液学 血液学 血液学
背景情况:
- 研究了手术期间的血液回收与心肺旁路术 (CPB) 后的凝血障碍之间的联系.
- 评估了用于疾病诊断的常规凝血测试和血栓形成显微镜 (TEG).
研究的目的:
- 为了确定手术内救血是否会影响CPB后的凝血功能.
- 评估细胞救援与术后出血或凝血病之间的关系.
主要方法:
- 对92名接受CPB心血管手术的患者进行了前性观察性研究.
- 在CPB之前评估的凝血功能,以及在0和1小时后的蛋白质胺的管理.
- 评估了血小板计数,纤维素素,TEG参数,并确定了凝血障碍的标准.
主要成果:
- 57.6%的患者接受了手术内细胞挽救; 60.9%的患者出现了凝血障碍.
- 在细胞救援和非救援组之间,凝血障碍发病率没有显著差异 (p=0.542).
- 内科手术救血与凝血障碍 (OR 1.329,p=0.547) 或排水量增加无关.
结论:
- 在手术内挽救血液并没有显著增加CPB后凝血障碍的发生率.
- 挽救血液与通过TEG或常规测试测量的改变的凝血参数没有相关性.
- 这些发现表明,手术内血液回收对于心脏手术后的凝血状况是安全的.
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