亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Dialectical analysis of heparin residue in perioperative period of off-pump coronary artery bypass grafting

医学 肝素 围手术期 麻醉 鱼精蛋白 血栓弹性成像 心肌梗塞 动脉 外科 体外循环 非体外循环冠状动脉搭桥术 输血 旁路移植 心脏病学 凝结 内科学
作者
Dalei Guo,Yan Liu,Pixiong Su,Xitao Zhang,Jun Yan,Song Gu,Jie Gao,Yulin Gou,Xin Yue,Qianwei Wang
出处
期刊:Chinese Journal of Thoracic and Cardiovaescular Surgery 卷期号:36 (03): 180-184
标识
DOI:10.3760/cma.j.cn112434-20190521-00167
摘要

Objective To investigate the best neutralization ratio of protamine and heparin during off-pump coronary artery bypass grafting(OPCABG) by analyzing the advantages and disadvantages of heparin residue after OPCABG. Methods From July 2018 to January 2019, 112 patients undergoing elective OPCABG were included in this study. The patients’ whole blood was drawn at 2 time points, including before entering operating room and entering intensive care unit, to receive thrombelastography(TEG) and heparinase-modified thromboelastography(hmTEG) . Conventional coagulation indexes such as activated coagulation time(ACT) were also detected. All the patients were divided into 3 groups, the non-heparin residue group(30 cases), heparin residue group 1(42 cases) and heparin residue group 2(40 cases) according to the laboratory results of TEG, hmTEG and ACT. We observed the dosage of each group of protamine and heparin, as well as the ratio of heparin and protamine. The changes of R time in TEG and ACT between 3 groups were analyzed and compared. Postoperative chest tube drainage at postoperative 12 h and 48 h, cTnI peak value, incidence of perioperative myocardial infarction(MI), incidence of reoperation and poor wound healing, amount of blood loss and transfusion, and acute renal injury were compared between the 3 groups. Results No significant trio-group differences existed in basic clinical characteristics(all P>0.05). Postoperative R(CKH)time was similar in the 3 groups(P>0.05). Comparing with heparin residue group 1 and heparin residue group 2, the ACT after protamine neutralizing heparin and postoperative R time were decreased, the dosage of protamine, ratio of heparin and protamine, cTnI peak value were increased in the non-heparin residue group(P 0.05). The perioperative myocardial infarction, incidence of reoperation and poor wound healing, postoperative acute renal injury and time of in ICU stay showed no significant differences between the 3 groups(P>0.05). Conclusion Moderate heparin residue after OPCAB suggests that it has myocardial protective effect, and does not significantly increase the risk of bleeding. A large number of heparin residues can affect the coagulation function and lead to bleeding tendency, increase the amount of blood loss and transfusion. It is reasonable to make ACT after protamine neutralize heparin higher than the level of ACT before operation, and not higher than 20% of the level before operation. Key words: Heparin; Protamine; Coronary artery bypass grafting, off-pump; Thromboelastograph
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
春山完成签到 ,获得积分10
1秒前
2秒前
科研通AI5应助科研通管家采纳,获得10
3秒前
脑洞疼应助科研通管家采纳,获得10
3秒前
3秒前
3秒前
4秒前
贪玩小小完成签到 ,获得积分10
7秒前
15秒前
学渣路过完成签到,获得积分0
18秒前
satisusu完成签到 ,获得积分10
21秒前
搜文献的北北完成签到,获得积分10
23秒前
好巧完成签到,获得积分10
24秒前
27秒前
糯米完成签到 ,获得积分10
29秒前
XING完成签到 ,获得积分10
34秒前
35秒前
35秒前
喂喂发布了新的文献求助10
41秒前
41秒前
一颗滚石发布了新的文献求助20
46秒前
学海行舟完成签到 ,获得积分10
51秒前
1分钟前
1分钟前
nicenice发布了新的文献求助10
1分钟前
咕噜噜完成签到,获得积分10
1分钟前
闫雪发布了新的文献求助10
1分钟前
1分钟前
1分钟前
1分钟前
Simpson完成签到 ,获得积分10
1分钟前
www发布了新的文献求助10
1分钟前
我是老大应助ceeray23采纳,获得20
1分钟前
李爱国应助zzzkyt采纳,获得10
1分钟前
lb001完成签到 ,获得积分10
1分钟前
zzjjyy完成签到,获得积分10
1分钟前
小刘发布了新的文献求助10
1分钟前
1分钟前
zzzkyt完成签到,获得积分10
1分钟前
万能图书馆应助www采纳,获得10
1分钟前
高分求助中
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3990012
求助须知:如何正确求助?哪些是违规求助? 3532047
关于积分的说明 11256141
捐赠科研通 3270918
什么是DOI,文献DOI怎么找? 1805105
邀请新用户注册赠送积分活动 882270
科研通“疑难数据库(出版商)”最低求助积分说明 809216