Risk factors for blood coagulation abnormality in patients undergoing off-pump coronary artery bypass grafting
10.3760/cma.j.issn.0254-1416.2017.08.005
- VernacularTitle:非体外循环冠状动脉旁路移植术患者凝血功能异常的危险因素
- Author:
Haidong ZHOU
1
,
2
;
宁波市第一医院麻醉科
;
Yijun CHEN
;
Jungang ZHENG
;
Xiangming FANG
;
Guohao XIE
Author Information
1. 310003 杭州市,浙江大学医学院附属第一医院麻醉科
2. 宁波市第一医院麻醉科
- Keywords:
Coronary artery bypass,off-pump;
Blood coagulation,abnormal;
Risk factors
- From:
Chinese Journal of Anesthesiology
2017;37(8):914-917
- CountryChina
- Language:Chinese
-
Abstract:
Objective To screen the risk factors for blood coagulation abnormality in patients undergoing off-pump coronary artery bypass grafting (OPCABG).Methods A total of 140 patients undergoing elective OPCABG were included in this study,and combined intravenous-inhalational anesthesia was performed during operation.The patients were divided into normal group and abnormal group according to whether or not blood coagulation abnormality developed during operation and within 48 h after operation.The data such as gender,age,body mass index,American Society of Anesthesiologists physical status,the number of operation per year for surgeons,comorbidities (hypertension and diabetes mellitus),preoperative hematocrit (Hct),left ventricular ejection fraction,arterial oxygen pressure,liver function,operation time and requirement for intraoperative continuous cardiac output monitoring,positive end expiratory pressure,tranexamic acid,ulinastatin and hydroxyethyl starch,postoperative acidosis and hypothermia were recorded.Results Blood coagulation abnormality was found in 43 patients,and the incidence was 31％.The results of logistic regression analysis showed that the number of operation per year for surgeons＜ 50,preoperative abnormal liver function,preoperative Hct＜35％,surgery time≥240 min,no use of continuous cardiac output monitoring during operation and postoperative hypothermia were risk factors for blood coagulation abnormality in patients undergoing OPCABG.Conclusion The number of operation per year for surgeons＜50,preoperative abnormal liver function,preoperative Hct ＜ 35％,operation time ≥ 240 min,no use of continuous cardiac output monitoring during operation and postoperative hypothermia are risk factors for blood coagulation abnormality in patients undergoing OPCABG.
