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洗涤式自体血回输对非停跳冠脉搭桥术患者脑氧代谢的影响

徐霞 胡礼宏

中国现代医生2018,Vol.56Issue(13):1-4,9,5.
中国现代医生2018,Vol.56Issue(13):1-4,9,5.

洗涤式自体血回输对非停跳冠脉搭桥术患者脑氧代谢的影响

Effect of washed autologous blood transfusion on cerebral oxygen metabolism in patients with off-pump coronary artery bypass surgery

徐霞 1胡礼宏2

作者信息

  • 1. 宁波市医疗中心李惠利医院麻醉科,浙江宁波 315000
  • 2. 宁波市医疗中心李惠利东部医院麻醉科,浙江宁波 315000
  • 折叠

摘要

Abstract

Objective To investigate the effect of washed autologous blood transfusion on cerebral oxygen metabolism in patients with off-pump coronary artery bypass surgery. Methods 60 patients who would undergo off-pump coronary artery bypass surgery were randomly divided into control group and observation group. The control group received allogeneic blood as needed. The observation group received washed autologous blood transfusion and the right amount of allogeneic blood as needed. Blood were collected from the internal jugular vein and the radial artery before surgery(Ti), at the end of the surgery (T2) and 24 h after the surgery (T3) to perform blood gas analysis, in order to calculate indexes of CER02, Sjv02, Da-jv02 and VADL. Cases and amount of allogeneic transfusion were recorded during operation and 24 h after the surgery. Postoperative cognitive dysfunction (POCD) was assessed by postoperative simple intelligent examination method on the first day before operation and 1, 3 and 7 days after operation. Results The cases and amount of allogeneic transfusion in the observation group were significantly lower than those in the control group. The incidence of POCD in the observation group was significantly lower than the control group. Da-jv02 and CERO2 at T1, T2 and T3 in the control group showed no significant difference. Da-jv02 and CER02 of the observation group in T2 and T3 were significantly lower than T1 and control group(P<0. 05). Sjv02 in control group was significantly higher in T2 than T1, and Sjv02 in T2 and T3 in observation group were significantly higher than Tl and control group (P<0. 05). There was no significant difference in VADL between the two groups(P>0. 05). Conclusion The application of washed autologous blood transfusion in off-pump coronary artery bypass surgery can effectively maintain the circulation stability, reduce allogeneic transfusion, increase oxygen supply to brain tissue and reduce cerebral oxygen consumption.

关键词

自体血回输/冠脉搭桥术/脑氧代谢/术后认知功能障碍

Key words

Autologous blood transfusion/Coronary artery bypass/Cerebral oxygen metabolism/Postoperative cognitive dysfunction

分类

医药卫生

引用本文复制引用

徐霞,胡礼宏..洗涤式自体血回输对非停跳冠脉搭桥术患者脑氧代谢的影响[J].中国现代医生,2018,56(13):1-4,9,5.

基金项目

浙江省宁波市医学科技计划项目(2016A42) (2016A42)

中国现代医生

1673-9701

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