110例冠状动脉旁路移植患者围术期的血栓弹力图.docVIP

110例冠状动脉旁路移植患者围术期的血栓弹力图 　　[摘要] 目的 应用血栓弹力图比较非体外循环下冠状动脉旁路移植术和体外循环下冠状动脉旁路移植术患者围术期的凝血功能，结合血小板计数，分析体外循环对冠状动脉旁路移植患者凝血功能的影响。 方法 2013年6月～2014年7月行单纯冠状动脉旁路移植术的110例患者，随机分为非体外循环组52例和体外循环组58例，于入手术室后、入ICU时和术后24 h 3个时间点分别采全血，作血栓弹力图和测定血小板计数。 结果 入ICU时血栓弹力图的3个参数，R时间[非体外循环组（5.88±1.51） min，体外循环组（4.76±1.35）min，P=0.0001]、最大幅度[（57.6±10.1）mm，（51.3±9.2）mm，P=0.0009]及Lysis 30[（0.88±0.25）%，（1.22±0.38）%，P=0.0000]，和血小板计数[（112±35）×109/L，（93±30）×109/L，P=0.0227）]在两组间有差异，但术后24 h差异消失。 结论 体外循环对冠状动脉旁路移植术患者的凝血功能有一定的影响，但持续时间不超过术后24 h。 　　[关键词] 血栓弹力图；血小板；体外循环；冠状动脉旁路移植术 　　[中图分类号] R654.2 [文献标识码] A [文章编号] 1673-9701（2015）23-0024-04 　　Perioperative thrombelastograph of 110 patients with coronary artery bypass graft 　　YANG Xiao1 YANG Guoqiang2 MENG Li3 　　1.Department of Laboratory， Zhengzhou Peoples Hospital， Zhengzhou 450003， China； 2.Department of Laboratory， Yihe Hospital of Zhengzhou Peoples Hospital， Zhengzhou 450000， China； 3.ICU of Cardiological Surgery， Zhengzhou Peoples Hospital， Zhengzhou 450003， China 　　[Abstract] Objective To compare the perioperative coagulation function of the patients with non-extracorporeal circulation coronary artery bypass graft and the patients receiving extracorporeal circulation coronary artery bypass graft through thrombelastograph and analyze the influence of extracorporeal circulation on the coagulation of patients receiving coronary artery bypass graft. Methods A total of 110 patients who received simple coronary artery bypass graft from June 2013 to July 2014 were randomly divided into the non-extracorporeal circulation group with 52 patients and the extracorporeal circulation group with 58 patients. The patients’ whole blood was drawn at 3 time points， including right after entering operating room， when entering ICU and 24 hours after surgery， received thrombelastography and blood platelet count measurement. Results The two groups were different in the 3 thrombelastograph parameters when entering ICU， including R time [（5.88±1.51） minutes for non-extracorporeal