中国体外循环杂志2017，Vol.15Issue(3)：136-140,5.DOI:10.13498/j.cnki.chin.j.ecc.2017.03.03
主动脉弓置换术后血小板功能改变及影响因素
Changes in function of platelet after total aortic arch replacement and their influencing factors
陈良 1姚婧鑫 1吕琳 1龙村 1楼松1
作者信息
- 1. 100037 北京,中国医学科学院,北京协和医学院,国家心血管病中心,阜外心血管病医院体外循环科
- 折叠
摘要
Abstract
Objective To evaluate the platelet function and blood coagulation of patients received thoracic aortic procedures with deep hypothermic circulatory arrest (DHCA),and to investigate their influencing factors.Methods The study consisted of 50 patients scheduled for aorta replacement undergoing DHCA between June 2014 and March 2015.Patients with re-operation,prescription antiplatelet drugs within 7 days before operation,onset time over 30 days and hematological diseases were excluded.Function of platelet and coagulation were tested by thrombelastogram (TEG) at two intervals,namely after anesthesia induction (T1) and 5 mins after protamine neutralization (T2).Blood routine examination and coagulating time test were also included.Results Compared with before cardiopulmonary bypass (CPB),MA value and fibrinogen (FIB) significantly reduced on T2 (P<0.001,P<0.001).Platelet count and hemoglobin concentration were both statistically decreased after protamine neutralization(P<0.001,P<0.001).There was a liner relationship between platelet function and platelet count before CPB (r=0.76,P=0.008).The correlation between function of platelet before operation and onset time was quadratic curve relationship (R2=0.551,P<0.001).Multivariate logistic regression analysis revealed that female (OR=0.097,P=0.047) and body mass index (OR=1.197,P=0.036) were risk factors associated with platelet transfusion at the end of CPB,while the function of platelet (OR=0.852,P=0.026) before surgery was a protective factor.The area under the ROC curve of MA before surgery on platelet transfusion was 0.843 (95％CI: 0.660-1.000,P=0.004).The specificity of MA<59.95mm was 75％,the sensitivity was 93％.Conclusion The levels of FIB and platelet function significantly decreased at the end of CPB,while most of patients'' platelet functions were at normal range.Blood platelet transfusion might be more reasonable for patients of female,lower BMI and MA <59.95mm before surgery.关键词
深低温停循环/全主动脉弓置换术/血小板功能Key words
Deep hypothermic circulatory arrest/Total aortic arch replacement/Platelet function引用本文复制引用
陈良,姚婧鑫,吕琳,龙村,楼松..主动脉弓置换术后血小板功能改变及影响因素[J].中国体外循环杂志,2017,15(3):136-140,5.
