| Objective:To investigate the relationship between the time of preoperative dual antiplatelet therapy（DAPT）and preoperative platelet count and the drainage volume in 24hs after operation in patients undergoing off-pump coronary artery bypass grafting（OPCABG）.Methods:From January 2014 to December 2018,402 patients firstly admitted to the Second Hospital of Hebei Medical University and underwent OPCABG were selected.According to the preoperative antiplatelet treatment,preoperative aspirin（100 mg/d）combined with clopidogrel（75 mg/d）for 5days and within 5 days for the DAPT group,n=314.Preoperative aspirin（100 mg/d）combined with clopidogrel（75 mg/d）for more than 5 days as a control group,n=88.The DAPT group was subdivided according to preo-perative platelet counts,with platelet counts at 100200×109/L for group A,n=156,and platelet counts at 200300×109/L for group B,n=158.The control group was subdivided according to preoperative platelet counts,with platelet counts at 100200×109/L for group C,n=44,and platelet counts at200300×109/L for group D,n=44.Group A was subdivided according to the number of days the DAPT is stopped before surgery.DAPT was stopped for 0 day before surgery,as group A0,n=82。DAPT was stopped for 1 day before surgery,as group A1,n=24.DAPT was stopped for 2 days before surgery,as group A2,n=13.DAPT was stopped for 3 days before surgery,as group A3,n=15.DAPT was stopped for 4 days before surgery,as group A4,n=10.DAPT was stopped for 5 days before surgery,as group A5,n=12.Group B was subdivided according to the number of days the DAPT is stopped before surgery.DAPT was stopped for 0 day before surgery,as group B0,n=71。DAPT was stopped for 1 day before surgery,as group B1,n=20.DAPT was stopped for 2 days before surgery,as group B2,n=18.DAPT was stopped for 3 days before surgery,as group B3,n=15.DAPT was stopped for4 days before surgery,as group B4,n=20.DAPT was stopped for 5 days before surgery,as group B5,n=14.The general data of the patients were observed.The relationship between the time of preoperative dual antiplatelet therapy and preoperative platelet counts with drainage volume at 24hs after operation was found by comparative analysis.Results:1.The drainage volume in 24hs after operation in the DAPT group was significantly higher than that in the control group,and the difference was statistically significant.（P<0.05）.2.There was a statistically significant difference in intraoperative autologous blood transfusion,intraoperative and postoperative plasma input between group A and group C（P<0.05）.There was a statistically significant difference in intraoperative autologous blood transfusion and postoperative plasma input between B and D group（P<0.05）.3.There was a positive correlation between the intraoperative blood transfusion volume,the intraoperative and postoperative plasma input volume and the 24hs postoperative drainage volume in group A（P<0.05,r=0.172,r=0.207,r=0.367）.There was a positive correlation between the intraoperative blood transfusion volume,the postoperative plasma input volume and the24hs postoperative drainage volume in group B（P<0.05,r=0.199,r=0.296）.4.There was significant difference in the drainage volume in 24hs after operation between A0,A1,A2,A3 and C groups（P<0.05）.There was no significant difference in the drainage volume in 24hs after operation between the A4,A5 and C groups（P>0.05）.There was significant difference in the drainage volume in 24hs after operation between B0,B1 and D groups（P<0.05）.There was no significant difference in the drainage volume in 24hs after operation between the B2,B3,B4,B5 and D groups（P>0.05）.Conclusions:1.The patients taking DAPT treatment until 4 days before surgery and the preoperative platelet counts were between 100200×109/L did not increase the patient’s drainage volume in 24hs after operation.The more intraoperative blood transfusion volume,the more drainage volume in 24hs after operation,and the more intraoperative and postoperative plasma input volume.2.The patients taking DAPT treatment until 2 days before surgery and the preoperative platelet counts were between 200300×109/L did not increase the patient’s drainage volume in 24hs after operation.The more intraoperative blood transfusion volume,the more drainage volume in 24hs after operation,and the more postoperative plasma input volume. |
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