CAJ | 학술논문

目的通过分析不同时间停用氯吡格雷和阿司匹林对非体外循环下冠状动脉旁路移植术(OPCAB)围手术期出血和输血的影响,探讨停药的最佳时机.方法 146例接受OPCAB手术的病人被分为3组:停用氯吡格雷和阿司匹林大于5d组(第1组);3～5 d组(第2组);小于3d组(第3组).应用统计学方法比较各组术后心包纵隔引流量、血制品用量和二次开胸手术止血发生率.结果第2组比第1组术后引流平均增多约100ml,输注红细胞未见明显增多.第3组比第2组引流平均增多约590ml,输注红细胞明显增多.各组二次开胸手术止血的发生率差异无统计学意义.结论氯吡格雷和阿司匹林可以在OPCAB术前3～5 d停用.
목적 통과분석불동시간정용록필격뢰화아사필림대비체외순배하관상동맥방로이식술(OPCAB)위수술기출혈화수혈적영향,탐토정약적최가시궤.방법 146례접수OPCAB수술적병인피분위3조:정용록필격뢰화아사필림대우5d조(제1조);3～5 d조(제2조);소우3d조(제3조).응용통계학방법비교각조술후심포종격인류량、혈제품용량화이차개흉수술지혈발생솔.결과 제2조비제1조술후인류평균증다약100ml,수주홍세포미견명현증다.제3조비제2조인류평균증다약590ml,수주홍세포명현증다.각조이차개흉수술지혈적발생솔차이무통계학의의.결론 록필격뢰화아사필림가이재OPCAB술전3～5 d정용.
Objective There has been no agreement to when should the patient discontinue clopidogrel and aspirin before offpump coronary artery bypass grafting(OPCAB). The aim of this study was to retrospectively evaluate the effects of clopidogrel and aspirin on bleeding and use of blood products after OPCAB and to fred the best time to stop the drugs. Methods 146 patients scheduled for OPCAB were divided into three groups: clopidogrel and aspirin discontinued mare than 5 days before surgery(group 1), the drugs discontinued until 3-5 days before surgery(group 2) and both medications continued within 2 days of surgery(goup 3). Chest tube drainage and blood products transfusion requirement and reoperation for bleeding were recorded respectively for statistical analysis. Resalts The mean volume of chest drainage was increased in group 2 (100 ml) than group 1. But the amount of blood products required were similar between the two groups. Group 3 is associated with increased chest drainage of 590ml, and an increase in blood product usage than group 2. No significant difference was found on the rate for re-exploration among the three groups. Conclusion Clopidogrel and aspirin may be continued until 3 to 5 days before surgery in patients undergoing OPCAB.