The Clinical Research Of The Relationship Between Individual Sensitivity Of Heparin And Postoperative Hemorrhage

Objective:To explore the correlation between the difference in heparin sensitivity and postoperative hemorrhage among different individuals and lay a foundation for the establishment of individual heparin anticoagulation strategy.Methods: A total of 120 adult patients undergoing cardiac surgery under cardiopulmonary bypass(CPB)were selected.Preoperative antithrombin III(ATIII)activity and preoperative activation of Clotting Time of whole blood(ACT)were measured.2.5 mg/kg first heparin was given after sternal opening.After 5 minutes,measure the ACT value.The patients were grouped according to the ACT results measured after the first heparinization(ACT<480s group,ACT 480-750 s group,and ACT>750s group),and if the ACT value did not meet the turnaround requirement(ACT>480s),the patient was continued.After heparin 0.5 mg/kg was added until the ACT value reached the standard,the thoracic drainage at 24 hours after operation was recorded and compared.Detailed records of general patient data,blood loss during surgery,and intraoperative and postoperative blood transfusions.Results: The number of patients in the three groups was 25 in the ACT<480 s group,60 in the ACT 480-750 s group,and 32 in the ACT>750s group.There was a statistically significant difference between the three groups of data(p<0.05).,ACT>750s group and ACT<480s group were significantly higher than ACT480-750 s group,the difference was statistically significant(p<0.05);ACT<480s group and ACT > 750 s group had no statistical difference Significance(p>0.05).Conclusions: Heparin sensitivity in patients undergoing cardiopulmonary bypass is associated with postoperative bleeding.The patients with ACT values between 480 and 750 s have the lowest blood loss.Therefore,to control ACT in the range of 480-750 s can not only meet the requirements of anticoagulation,but also can reduce the perioperative bleeding-related complications and reduce the mortality of cardiac surgery patients.