CAJ | 학술논문

目的探讨将急性等容血液稀释(ANH)自体输血应用于老年人冠状动脉旁路移植(CABG)手术的可行性及效果. 方法 60例接受体外循环心脏停搏下单纯CABG手术的65岁及以上老年冠心病患者,其中研究组30例术中应用ANH自体输血技术,对照组30例未应用该技术.结果全部病例完全再血管化,手术过程平稳,氧供需平衡,未提示组织缺氧,未发生严重并发症及手术死亡.研究组和对照组病例在心肌保护效果、凝血功能、肝功能、肾功能、血糖、负氮平衡、术后引流量等方面的指标均无统计学差异(均P＞0.05).病例异体输红细胞悬液研究组(0.9±0.9)u低于对照组(2.5±1.2)u(t=2.704,P＜0.01). 结论遵循适当病例选取原则情况下,ANH自体输血应用于老年人CABG手术安全可行且临床效果满意.
목적 탐토장급성등용혈액희석(ANH)자체수혈응용우노년인관상동맥방로이식(CABG)수술적가행성급효과. 방법 60례접수체외순배심장정박하단순CABG수술적65세급이상노년관심병환자,기중연구조30례술중응용ANH자체수혈기술,대조조30례미응용해기술.결과 전부병례완전재혈관화,수술과정평은,양공수평형,미제시조직결양,미발생엄중병발증급수술사망.연구조화대조조병례재심기보호효과、응혈공능、간공능、신공능、혈당、부담평형、술후인류량등방면적지표균무통계학차이(균P＞0.05).병례이체수홍세포현액연구조(0.9±0.9)u저우대조조(2.5±1.2)u(t=2.704,P＜0.01). 결론 준순괄당병례선취원칙정황하,ANH자체수혈응용우노년인CABG수술안전가행차림상효과만의.
Objective To investigate effects of acute normovolemic hemodilution (ANH) used in coronary artery bypass graft (CABG) surgery in elderly patients.Methods 60 elderly patients (aged ≥65 years) received CABG surgery under cardiopulmonary bypass,of which 30 patients using ANH techniques and 30 patients without ANH techniques.Results All patients were revascularized completely with stable surgical procedure,no serious complications and no operative mortality were found.Oxygen supplying was balanced with demanding,without tissue hypoxia.Indicators of the myocardial protective effect,coagulation,liver function,kidney function,glucose metabolism,negative nitrogen balance,and postoperative drainage volume were not significantly different between the two groups (P＞0.05).Allogeneic blood transfusion volume was significantly lower in study group than in control group[(0.9±0.9)U vs.(2.5±1.2)U,t=2.704,P＜0.01].Conclusions The ANH technique used in CABG operation in appropriate elderly patient is feasible and safe,with satisfactory clinical results.