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氯吡格雷停药时间对非体外循环冠脉搭桥术患者出血的影响 被引量:6
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作者 田丽娟 刘琳琳 +1 位作者 杨静 纪宏文 《北京医学》 CAS 2019年第2期142-145,共4页
目的探讨术前氯吡格雷停药时间对非体外循环下冠状动脉旁路移植术(off-pump coronary artery bypassgrafting, OPCAB)患者出血和血小板功能的影响。方法本研究为前瞻性观察性研究,收集2016年4~7月于中国医学科学院阜外医院择期行OPCAB... 目的探讨术前氯吡格雷停药时间对非体外循环下冠状动脉旁路移植术(off-pump coronary artery bypassgrafting, OPCAB)患者出血和血小板功能的影响。方法本研究为前瞻性观察性研究,收集2016年4~7月于中国医学科学院阜外医院择期行OPCAB的成年患者115例,根据术前停用氯吡格雷时间分为3组:A组(n=35)停药时间<5 d,B组(n=40)停药时间5~7 d,C组(n=40)停药时间>7 d。分别于麻醉诱导后(T1)、手术结束时(T2)行血栓弹力图(Thrombelas-tograghy, TEG)和血小板图检测,记录术后6 h和24 h纵隔胸腔引流量,异体输血情况,术后机械通气时间,重症监护室(intensive care unit, ICU)停留时间和围术期不良事件发生情况。结果与A组比较,T1时C组血凝块强度最大振幅(maxi-mum amplitude, MA)值[(62.6±5.7)mm vs.(59.5±6.4)mm,P <0.05]和ADP诱导的血小板最大振幅(MA_(ADP))值[(53.0±11.6)mm vs.(46.2±13.0)mm,P <0.05]显著增加;C组术后6 h出血量减少[350(250,460)ml vs. 280(193,358)ml,P <0.05],术后ICU停留时间明显缩短[43(22,79)h vs. 30(19,56)h,P <0.05]。A组与B组比较,术后出血和ICU停留时间差异均无统计学意义(P> 0.05)。T2时,与A组比较,C组和B组MA值和MAADP亦明显增加,差异有统计学意义(P <0.05)。3组患者术后24 h出血量,异体血输注率,术后机械通气时间和围术期不良反应发生率差异均无统计学意义(P> 0.05)。结论术前氯吡格雷停药时间<5 d增加OPCAB患者术后早期出血,延长ICU停留时间。血小板功能低下是凝血功能障碍的主要原因。 展开更多
关键词 冠状动脉旁路移植术 血栓弹力图 血小板功能 出血
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Anesthesia Management at Fuwai Hospital:Practice,Evidence and Outcomes 被引量:1
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作者 Yuntai Yao Lixian He Liping Li 《Chinese Medical Sciences Journal》 CAS CSCD 2021年第3期234-251,共18页
Fuwai Hospital was established in 1956 and the Anesthesia Department of Fuwai Hospital was one of the earliest anesthesia departments then in China.Under the leadership of several department directors and with the con... Fuwai Hospital was established in 1956 and the Anesthesia Department of Fuwai Hospital was one of the earliest anesthesia departments then in China.Under the leadership of several department directors and with the concerted efforts of all generations of colleagues,the Anesthesia Department of Fuwai Hospital has dramatically transformed,upgraded and modernized.For more than six decades,the Anesthesia Department has been providing high-quality peri-operative anesthesia care for cardiovascular surgeries,conducting innovative experimental and clinical researches,and offering comprehensive training on cardiovascular anesthesiology for professionals across China.Currently,Fuwai Hospital is the National Center for Cardiovascular Diseases of China and one of the largest cardiovascular centers in the world.The present review introduces the Anesthesia Department of Fuwai Hospital,summarizes its current practice of anesthesia management,the outcomes of cardiovascular surgeries at Fuwai Hospital,accumulates relevant evidence,and provides prospects for future development of cardiovascular anesthesiology. 展开更多
关键词 ANESTHESIA management cardiac surgery OUTCOME
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