摘要
Abstract
Objective To investigate the effectiveness and safety of recombinant activated factor(rFⅦa)in treating coagulopathy-related bleeding after coronary artery bypass grafting(CABG).Methods We retrospectively collected data of patients who experienced coagulopathy after undergoing CABG at Beijing Anzhen Hospital,Capital Medical University,from January 2021 to December 2021.Patients were divided into two groups based on whether they received treatment with recombinant activated factor Ⅶ(rFⅦa):the rFⅦa group and the control group.We collected perioperative information of patients,conducted statistical analysis,evaluated the effectiveness by comparing postoperative drainage,and assessed the safety by comparing thrombotic complications and outcomes after surgery.Result A total of 87 patients were included in this study,with 56 in the rFⅦa group and 31 in the control group.Among them,there were 52 patients undergoing isolated coronary artery bypass grafting and 35 patients undergoing other procedures,with a total of 55 undergoing cardiopulmonary bypass surgery.Compared with the control group,patients in the rFⅦa group had significantly shortened PT[11.90(10.50-14.20)seconds vs 14.35(13.50-17.65)seconds,P<0.001],higher levels of D-dimer[492.00(191.00-1220.00)ng/ml vs 276.50(158.00-463.50)ng/ml,P = 0.026],and less drainage at 12 hours[1170(800,1400)ml vs 1000(850,1500)ml,P = 0.032].Relevant indicators of safety:SPAP[29.00(23.00-37.00)mmHg vs 29.00(23.00-32.00),P = 0.617],perioperative myocardial infarction[8(14.29%)cases vs 5(16.13%)cases,P = 0.817],deep vein thrombosis[4(10.26%)cases vs 2(12.50%)cases,P>0.999],neurological injury[6(10.71%)cases vs 8(26.67%)cases,P = 0.109],all-cause mortality[8(14.29%)cases vs 8(25.81%)cases,P = 0.184]showed no statistical difference between the two groups.Conclusion Patients with coagulation dysfunction bleeding after coronary artery bypass grafting surgery have good efficacy and safety in hemostatic treatment with rFⅦa.And,it is crucial to closely monitor for symptoms and signs of thromboembolic complications,as well as relevant laboratory tests during the application of rFⅦa.关键词
心脏外科/冠状动脉旁路移植术/出血/重组活化因子ⅦKey words
Cardiac surgery/Coronary artery bypass grafting/Bleeding/Recombinant activated factor Ⅶ
