| At present,along with aging of population increasing aggravation in society,people’s dietary structure changed little by little,people’s living standard promoted gradually,cardiovascular disease became significant hidden trouble for people’s life threatening,while the acute coronary syndrome was the crisis in the cardiovascular disease.Along with surgical techniques complete gradually,coronary artery bypass grafting and cardiac catheterization intervention treatment had been widely applied for treating acute coronary syndrome and severity chronic coronary atherosclerosis.Because off-pump coronary artery bypass grafting had obvious advantages in reducing complications after cardiopulmonary bypass and operation time,and had active role in the prognosis of patients,so off-pump coronary artery bypass grafting was recognized more and more by each big hospital,became the main way to treat coronary heart disease in clinic.Objective:To evaluate the safety for patients with coronary heart disease in perioperative period and provide safer and powerful theoretical guidance for patients carrying out emergency coronary artery bypass graft in perioperative period by observing the dual antiplatelet therapy(DAPT)treating patient’s carrying out off-pump coronary artery bypass grafting(OPCABG)various indexes.Methods:The research object was 200 patients carrying out off-pump coronary artery bypass grafting(OPCABG)in cardiac surgery,the second hospital,Hebei medical university,November 2014 to January 2017,it could be divided into control group(N)and observation group(B)according to weather the dual antiplatelet drugs was discontinued for more than a week,countinuously monitored and recorded the patient out of room to the chamber of the hemodynamic parameters: systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),BIS,heart rate(HR),central venous pressure(CVP).Recorded two groups of patients with intraoperative and postoperative bleeding,blood transfusion and outcome indicators,to statistical indicators,and eventually came to the conclusion.Results:1 There was no significant differences in age,height and the basic vital signs between N group and B group(P>0.05).2 There was no statistically significant differences in all time points from out a room to in a room associated in hemodynamic parameters between N group and B group(P>0.05).3 N group and B group of intraoperative blood loss was(758.00 ± 476.06)ml and(1016.55 ± 597.98)ml respectively,there was statistically significant differences contrasting between two groups(P<0.05).4 N group and B group of intraoperative autologous blood back to the throughout was(407.53 ± 224.43)ml and(548.67 ± 310.55)ml respectively,there was statistically significant differences contrasting between two groups(P<0.05).5 N group and B group of postoperative volume of drainage was(337.15 ± 162.01)ml and(393.75 ± 211.42)ml respectively,there was statistically significant differences contrasting between two groups(P<0.05).6 There was no statistically significant differences in postoperative waking time,extubation time,postoperative intensive care unit stay time,length of hospital stay between N group and B group(P>0.05).7 There was statistically significant differences in intraoperative blood input variants(red blood cell and fresh frozen plasma,cryoprecipitate)between N group and B group(P<0.05).8 There was statistically significant differences(P<0.05)in the ratio of allogeneic blood transfused in addition to cryoprecipitate between N group and B group,there was no statistically difference(P>0.05)in red blood cell and fresh frozen plasma between N group and B group.9 N group and B group postoperative input variants,red blood cell and fresh frozen plasma had statistically significant(P<0.05),while cryoprecipitate and platelets were no statistically differences(P>0.05).10 N group and B group of the ratio of inputting allogeneic blood and blood was the same,red blood cell and fresh frozen plasma had statistically significant differences(P<0.05),while cryoprecipitate and platelets were no statistically differences(P<0.05).Conclusion:1 Comparing with non-dual antiplatelet therapy patients with coronary heart disease,dual antiplatelet therapy patients carrying out off-pump coronary artery bypass grafting(OPCABG)had increased significantly for intraoperative blood loss and intraoperative blood transfusion rate,this increased the difficulty for intraoperative management.However,intraoperative hemodynamic parameters of observation group comparing with control group was no significant differences,it suggested that the dual antiplatelet therapy intraoperative could guarantee the stable vital signs of patients with coronary artery disease.2 Compared with the control group,volume of drainage and blood transfusion rate had increased in postoperative for dual antiplatelet therapy patients with coronary heart disease carrying out off-pump coronary artery bypass grafting(OPCABG),this cleared the way for clinical and postoperative management of matters needing attention.3 Compared with the control group,intensive care unit stay time and length of hospital stay did not extend for dual antiplatelet therapy patients with coronary heart disease carrying out off-pump coronary artery bypass grafting(OPCABG),so it would provide a theory basis for the safety of the patients with coronary artery bypass surgery. |
PDF Full Text Request