CAJ | 학술논문

背景由于体外循环(cardiopulmonary bypass,CPB)技术在心脏手术中的应用,机体围术期可发生复杂的病理生理改变,对凝血功能的影响尤为显著.患者围术期凝血功能障碍可引起大量出血从而导致大量输血甚至需要再次手术,严重影响患者预后. 目的保护CPB心脏手术围术期凝血功能,减少出血和输血. 内容通过对近10年文献的复习,全面分析CPB引起患者围术期凝血功能紊乱的主要因素以及相应的防治措施. 趋向应通过多模式途径减少CPB对凝血功能的影响,当出现凝血功能异常时,应寻求病因对症处理,纠正患者凝血紊乱.
배경 유우체외순배(cardiopulmonary bypass,CPB)기술재심장수술중적응용,궤체위술기가발생복잡적병리생리개변,대응혈공능적영향우위현저.환자위술기응혈공능장애가인기대량출혈종이도치대량수혈심지수요재차수술,엄중영향환자예후. 목적 보호CPB심장수술위술기응혈공능,감소출혈화수혈. 내용 통과대근10년문헌적복습,전면분석CPB인기환자위술기응혈공능문란적주요인소이급상응적방치조시. 추향 응통과다모식도경감소CPB대응혈공능적영향,당출현응혈공능이상시,응심구병인대증처리,규정환자응혈문란.
Background The cardiopulmonary bypass brings about complex pathophysiological changes,especially blood coagulation disorders.Prolonged blood contacting with the artificial surface of the cardiopulmonary bypass circuit,severe hemodilution,high doses of heparin and hypothermia are all possible triggers of a coagulopathy which leads to excessive bleeding.Sometimes it might need surgical re-interventions.Objective To protect the coagulation function of patients undergoing cardiopulmonary bypass surgery is to reduce bleeding and blood transfusion.Content The literature about the pathophysiological changes and preventive measures of coagulopathy in patients undergoing open heart surgery with cardiopulmonary bypass in past ten years are discussed and updated in this review.Trend We should use a multi-modal approach to reduce the impact of CPB on coagulation function and correct coagulant dysfunction timely.