摘要
目的比较离心泵与滚压泵对体外循环下Stanford A型主动脉夹层术中血小板的影响。方法纳入拟行Stanford A型主动脉夹层手术的患者40例,按照随机数字表法分为离心泵组(20例)和滚压泵组(20例)。记录2组体外循环(CPB)时间、主动脉阻断时间、停循环时间、尿量、出血量、用血量、凝血功能、肝肾功能、血常规、术后胸腔引流量、机械通气时间、重症监护病房(ICU)停留时间、住院时间、并发症。分别在麻醉诱导后(T1)、鱼精蛋白中和后0.5 h(T2)、入ICU 4 h(T3)、入ICU 24 h(T4)、入ICU 48 h(T5)检测血小板α颗粒膜蛋白-140(GMP-140)、血小板因子4(PF4)水平,并进行血小板计数。结果 2组基线资料、术中指标(CPB时间、主动脉阻断时间、停循环时间、术中尿量、用血量、出血量)比较差异无统计学意义(P>0.05)。在T2~T4时,与滚压泵组相比,离心泵组血小板计数升高,PF4和GMP-140水平降低;入ICU 4 h和24 h离心泵组胸腔引流量和术后用血量明显少于滚压泵组(P<0.05),2组48 h胸腔引流量、机械通气时间、术后清醒时间、ICU停留时间、术后住院时间和并发症比较差异无统计学意义(P>0.05)。结论在Stanford A型主动脉夹层术中,离心泵可减少血小板激活和消耗,减少术后引流量和用血量。
Objective To compare the effect of centrifugal pump and roller pump on platelet in Stanford A-type aortic dissection under cardiopulmonary bypass(CPB).Methods A total of 40 patients who planned to undergo a surgery were enrolled,and they were divided into the centrifugal pump group(n=20) and the roller pump group(n=20) according to the random number table.Data of CPB time,aortic cross-clamp time,circulatory arrest time,blood consumption,coagulation function,liver and kidney function,blood routine,postoperative chest drainage,mechanical ventilation time,ICU(intensive care unit) length of stay,length of hospital stay,and complications were recorded in the two groups.Platelet α-granule membrane protein 140(GMP-140) and platelet factor 4(PF4) concentration and platelet count were detected after induction of anesthesia(T_(1)),0.5 h after fish sperm neutralization(T_(2)),4 h in ICU(T_(3)),24 h in ICU(T_(4)),and 48 h in ICU(T_(5)).Results There were no significant differences in baseline data and intraoperative indicators(CPB time,aortic cross-clamp time,circulatory arrest time,blood consumption,bleeding volume) between the two groups(P>0.05).At T_(2)-T_(4),compared with the roller pump group,platelet count was increased,and the concentration of PF4 and GMP140 decreased in the centrifugal pump.At 4 h and 24 h,the chest drainage and blood consumption were significantly less in the centrifugal pump group than those in the roller pump group(P<0.05).There were no significant differences in mechanical ventilation time,ICU stay time,length of hospital stay,48 h chest drainage and complications between the two groups(P>0.05).Conclusion In the operation of Stanford type A aortic dissection,the centrifugal pump can reduce platelet activation and consumption,and reduce postoperative bleeding and blood consumption.
作者
纪振华
武婷
姜楠
JI Zhen-hua;WU Ting;JIANG Nan(Graduate School of Tianjin Medical University,Tianjin 300070,China;Tianjin Chest Hospital,Tianjin Institute of Cardiovascular Disease)
出处
《天津医药》
CAS
北大核心
2021年第12期1287-1291,共5页
Tianjin Medical Journal
基金
天津市科技计划项目(18ZXDBSY00160)。
关键词
动脉瘤
夹层
体外循环
血小板计数
滚压泵
离心泵
aneurysm,dissecting
extracorporeal circulation
platelet count
roller pump
centrifugal pump
