|本期目录/Table of Contents|

[1]宋艳艳,田 辉,张玉京,等.多措施节约用血在心脏瓣膜置换手术中的应用[J].宁夏医科大学学报,2019,(06):626-628.[doi:10.16050/j.cnki.issn1674-6309.2019.06.019]
 SONG Yanyan,TIAN hui,ZHANG Yujing,et al.Application of Multiple Measures to Save Blood in Heart Valve Replacement Surgery[J].Ningxia Medical University,2019,(06):626-628.[doi:10.16050/j.cnki.issn1674-6309.2019.06.019]
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《宁夏医科大学学报》[ISSN:1005-8486/CN:64-1029/R]

卷:
期数:
2019年06期
页码:
626-628
栏目:
经验交流
出版日期:
2019-06-30

文章信息/Info

Title:
Application of Multiple Measures to Save Blood in Heart Valve Replacement Surgery
文章编号:
1674-6309(2019)06-0626-03
作者:
宋艳艳 田 辉 张玉京 李明亮 杨 剑 李艳婷
(宁夏医科大学总医院心脏大血管外科,银川 750004)
Author(s):
SONG Yanyan TIAN hui ZHANG Yujing LI Mingliang Yang Jian LI Yanting
(Department of Cardiac Surgery, the General Hospital of Ningxia Medical Unixersity, Yinchuan 750004,China)
关键词:
心脏瓣膜置换手术 节约用血体外循环
Keywords:
heart valve replacement surgeryblood-savingextracorporeal circulation
分类号:
R654.2
DOI:
10.16050/j.cnki.issn1674-6309.2019.06.019
文献标志码:
B
摘要:
目的 探讨心脏瓣膜置换手术节约用血措施及对术后并发症、引流量的影响。方法 回顾性分析2015年6月-12月、2016年6月-12月行体心脏瓣膜置换手术患者各80例,分别设为对照组(未采取多项措施节约用血)和研究组(采取多项措施节约用血),比较两组术后12h引流量、输血量及术后并发症、术后二次开胸情况。结果 采取多项措施节约用血后,研究组患者术后12h引流量、带机时间、ICU时间、术后感染、输血量均低于对照组(P均<0.05),两组术后急性肾功能衰竭、二次开胸及病死率差异无统计学意义(P>0.05)。结论 心脏瓣膜置换手术中采用自体血液净化回输、氨甲环酸应用、改良超滤、加强外科止血技术等综合措施可降低术后引流量及用血量,降低术后感染率。
Abstract:
Objective To discuss the effect of postoperative complications and volume of drainage after multiple measures to save blood in heart valve replacement surgery. Methods Since the beginning of 2016,our department has actively adopted the integrated blood saving methods to reduce the amount of blood transfusion in cardiac surgery. A total of 160 patients undergoing extracorporeal circulation heart valve replacement surgery were divided into 2 groups: control group(n=80),from June to December 2015 and test group(n=80),from June to December 2016. The volume of drainage after 12 hours,blood transfusion, postoperative complications,and secondary thoracotomy in two groups was analyzed. Results After taking many measures to save blood,the drainage volume,lead time,ICU time,postoperative infection and blood transfusion in the study group were lower than those in the control group(all P<0.05). There was no significant difference in acute renal failure, secondary thoracotomy and mortality between the two groups(P>0.05). Conclusion A lower rate of drainage,blood transfusion and postoperative infection complications can be realized effectively by applying multiple measures to save blood in heart valve replacement surgery.

参考文献/References:

[1] 龙村. 体外循环学[M]. 北京:人民军医出版社,2004.
[2] 李春艳,赵国英,王悦. 输血不良反应的几种类型及其机制[J]. 医疗装备,2006,19(4):48-49.
[3] Robert M. Bojar. 成人心脏外科围术期处理手册[M]. 高长青译. 北京:科学出版社,2007.
[4] Mengistu AM,B&hm KD,Boldt J,et al.The influence of aprotinin and tranexamic acid on platelet function and postoperative bloodloss in catdiac surgery[J]. Anesth Analg,2008,107(2):391-397.
[5] 马松峰,乔峻. 止血环酸对体外循环中血小板的保护作用[J]. 中华胸心血管外科杂志,1998,14(2):99-100.
[6] 傅杭祥,曹志方,张健. 心脏外科手术中节约用血的分析[J]. 中国医药指南,2013,11(18):744-745.
[7] 刘琛,王毓林,邵孟平. 综合省血方法降低心脏手术用血量[J]. 中国临床医学,2012,19(4):350-351.
[8] 杨玲. 围手术期综合血液保护在无血手术中的应用[J]. 吉林医学,2014,35(3):580.

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备注/Memo

备注/Memo:
收稿日期:2018-12-15
作者简介:宋艳艳,女,副主任医师,从事心脏外科临床工作。
更新日期/Last Update: 2019-06-30