Effects of autologous platelet-rich plasma on postoperative outcomes in patients undergoing Sun′s procedure
10.3760∕cma.j.issn.0254-1416.2019.10.017
- VernacularTitle:自体富血小板血浆对孙氏手术患者术后转归的影响
- Author:
Wenzhi TIAN
1
;
Jianxu ER
;
Liang LIU
;
Qingliang CHEN
;
Jiange HAN
Author Information
1. 天津市胸科医院麻醉科 天津市心血管病研究所 300051
- Keywords:
Platelet-rich plasma;
Aneurysm,dissecting;
Prognosis
- From:
Chinese Journal of Anesthesiology
2019;39(10):1216-1220
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of autologous platelet-rich plasma(aPRP)on postop-erative outcomes in the patients undergoing Sun's procedure.Methods One hundred and sixteen patients with acute Stanford type A aortic dissection of both sexes,aged 18-64 yr,with body mass index of 19-34 kg/m2,of American Society of Anesthesiologist physical status Ⅳ,were divided into aPRP group(group A)and control group(group C)by a random number table method,with 58 cases in each group.After an-esthesia induction and intubation,aPRP preparation was completed before surgery in group A,and surgery began in group C.After heparin neutralization,group A received retransfusion of platelet-rich plasma,while group C received conventional fluid management.Thromboelastography was performed on all patients,and the results were recorded.The intraoperative amount of allogeneic blood products and blood loss were recorded in two groups.Plasma concentrations of tumor necrosis factor-alpha(TNF-α)and interleukin-6(IL-6)were recorded after anesthesia induction(T0),immediately after completion of aPRP preparation(T1),3 h after heparin neutralization(T2),and at 24 and 48 h after surgery(T3,4).The volume of post-operative chest drainage and amount of allogeneic blood products,mechanical ventilation time,lengths of intensive care unit and hospital stay,incidence of important complications and fatality rate within 30 days after surgery were also collected.Results Compared with group C,the intraoperative amount of allogeneic blood products and blood loss were significantly reduced,α angle and MA values of thromboelastograph were larger,plasma concentrations of TNF-α and IL-6 were reduced at T2,3,postoperative chest drainage volume and allogeneic blood transfusion were reduced,the postoperative mechanical ventilation time and length of hospital stay were shortened,and the incidence of pulmonary complications was reduced in group A(P＜0.05).There was no significant difference in the length of intensive care unit stay,incidence of other complications or fatality rate within 30 days after surgery between the two groups(P>0.05).Conclu-sion aPRP can improve postoperative outcomes in the patients undergoing Sun's procedure.
