非体外循环冠状动脉旁路移植术大部分患者可不异体输血

姚京; 陈霞; 程吉; 曹钰琨; 李悦; 王立清; 张红超

doi:10.12125/j.chj.202006056

非体外循环冠状动脉旁路移植术大部分患者可不异体输血

Allogeneic blood transfusion is not required in most patients undergoing off-pump coronary artery bypass grafting

摘要

摘要:
目的分析非体外循环冠状动脉旁路移植术（off-pump coronary artery bypass grafting, OPCABG）异体输血的危险因素及分享减少异体输血的临床经验。
方法回顾性分析82例择期OPCABG受试者临床资料。
结果本组患者围术期异体输血的患者22例(27%)，输血组受试者，年龄偏大，女性较多，胸骨条件较差，血管条件差。完善术前准备，注意围术期用药，术中应用明胶海绵及毛毡片保护胸骨，术后注意护理可明显减少围术期异体输血。
结论高龄、女性、胸骨条件差是OPCABG围术期异体输血的危险因素。严格把握OPCABG不输血适应征，术前准备充分，术中操作精确，围术用药时机、剂量准确可以显著减少OPCABG围术期异体输血，保证手术远期治疗效果。

Abstract:
AIM To analyze the risk factors of blood transfusion in off-pump coronary artery bypass grafting and to share the clinical experience of reducing blood transfusion.
METHODS Clinical data of 82 elective OPCABG subjects were analyzed retrospectively.
RESULTS In this group, 22(27%) patients underwent blood transfusion during the perioperative period. Subjects in the transfusion group were older, females, with poor sternal condition and vascular condition.
CONCLUSION Old age, female and poor sternal condition are the risk factors of perioperative transfusion after OPCABG. With clinical indications, sufficient preoperative preparation, refined anastomosis technique, accurate medication off-pump coronary artery bypass grafting approach can offer excellent clinical outcomes and complete revascularization in coronary artery disease patients.

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