体外循环及非体外循环冠状动脉旁路移植术输血情况的对比与研究.docVIP

体外循环与非体外循环冠状动脉旁路移植术输血情况的对比研究 作者：赵涛,高长青,李伯君 作者单位：中国人民解放军总医院心血管外科，北京 100853 【摘要】 目的 对比研究常规冠状动脉旁路移植术（conventional coronary artery bypass grafting,CCABG）与非体外循环冠状动脉旁路移植术（off-pump coronary artery bypass，OPCAB）患者术中及术后输血量及输血费用的不同。方法 对345例行CABG的患者进行了术中、术后输血量及输血费用的统计，所有患者分为CCABG组135例，OPCAB组210例。分别统计两组患者术中及术后输红细胞量、血浆量、血小板量、输血总量以及各自相关费用。结果 CCABG组输血率显著高于OPCAB组（分别为82.2%和46.7%，P0.05），输红细胞量、输红细胞费用、输血浆量、输血浆费用、输血总量及输血总费用CCABG组均显著高于OPCAB组（P0.05），而输血小板量及输血小板费用两组之间无显著性差异（P0.05）。结论 与CCABG相比，OPCAB患者术中、术后输血量及输血费用显著减少，OPCAB对患者恢复有利，并能减轻患者经济费用。 【关键词】 冠状动脉旁路移植术；体外循环；输血 Comparison of Transfusion and Its Costs for Patients underwent Conventional Coronary Artery Bypass Grafting and Off-pump Coronary Artery Bypass ZHAO Tao,GAO Chang-qing,LI Bo-jun,XIAO Cang-song,WU Yang,YE Wei-hua, YANG Ming,LIU Guo-peng,REN Chong-lei (Department of Cardiovascular Surgery,General Hospital of PLA, Beijing 100853,China) Abstract: OBJECTIVE To compare the transfusion and its costs for patients underwent conventional coronary artery bypass grafting(CCABG) and off-pump coronary artery bypass(OPCAB). METHODS Three hundred and forty-five patients underwent coronary artery bypass grafting(CABG) were divided into two groups:CCABG group (135 cases) and OPCAB group(210 cases).The transfusion of red blood cell(RBC), fresh frozen plasma(FFP),platelet and total blood volume were recorded, and its costs were calculated respectively. RESULTS The transfusion and its costs of RBC and FFP of CCABG group were significantly higher than that of OPCAB group (P0.05),but there was no significant difference in the transfusion of platelet between the two groups(P0.05). CONCLUSION Less transfusion of blood and plasma products is required in OPCAB than that in CCABG, which is favorable to patients and can reduce the hospitalization costs. Key words： Coronary artery bypass grafting;Extracorporeal circulation;Transfusion 传统冠脉搭桥手术(conventional coronary