天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (12): 1287-1291.doi: 10.11958/20211132

• 临床研究 • 上一篇    下一篇

离心泵和滚压泵对体外循环下Stanford A型主动脉夹层术中血小板影响的比较

纪振华 1，2，武婷 2，姜楠 2△   

  1. 1天津医科大学研究生院（邮编300070）；2天津市胸科医院，天津市心血管病研究所
  • 收稿日期:2021-05-17 修回日期:2021-09-07 出版日期:2021-12-15 发布日期:2021-12-27
  • 通讯作者: 纪振华 E-mail:△通信作者 E-mail：771523283@qq.com
  • 作者简介:纪振华（1985），男，硕士在读，主治医师，主要从事体外循环方面研究。E-mail：15822550435@163.com
  • 基金资助:
    天津市科技计划项目（18ZXDBSY00160）

Comparison of the effects between centrifugal pump and roller pump on platelets during Stanford type A aortic dissection cardiopulmonary bypass

JI Zhen-hua1, 2, WU Ting2, JIANG Nan2△   

  1. 1 Graduate School of Tianjin Medical University, Tianjin 300070, China; 2 Tianjin Chest Hospital, Tianjin Institute of
    Cardiovascular Disease
    △Corresponding Author E-mail: 771523283@qq.com
  • Received:2021-05-17 Revised:2021-09-07 Published:2021-12-15 Online:2021-12-27

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摘要： 目的 比较离心泵与滚压泵对体外循环下Stanford A型主动脉夹层术中血小板的影响。方法 纳入拟行 Stanford A型主动脉夹层手术的患者40例，按照随机数字表法分为离心泵组（20例）和滚压泵组（20例）。记录2组体 外循环（CPB）时间、主动脉阻断时间、停循环时间、尿量、出血量、用血量、凝血功能、肝肾功能、血常规、术后胸腔引流 量、机械通气时间、重症监护病房（ICU）停留时间、住院时间、并发症。分别在麻醉诱导后（T1）、鱼精蛋白中和后0.5 h （T2）、入ICU 4 h（T3）、入ICU 24 h（T4）、入ICU 48 h（T5）检测血小板α颗粒膜蛋白-140（GMP-140）、血小板因子4（PF4） 水平，并进行血小板计数。结果 2组基线资料、术中指标（CPB时间、主动脉阻断时间、停循环时间、术中尿量、用血 量、出血量）比较差异无统计学意义（P＞0.05）。在 T2~T4时，与滚压泵组相比，离心泵组血小板计数升高，PF4 和 GMP-140水平降低；入ICU 4 h和24 h离心泵组胸腔引流量和术后用血量明显少于滚压泵组（P＜0.05），2组48 h胸 腔引流量、机械通气时间、术后清醒时间、ICU停留时间、术后住院时间和并发症比较差异无统计学意义（P＞0.05）。 结论 在Stanford A型主动脉夹层术中，离心泵可减少血小板激活和消耗，减少术后引流量和用血量。

关键词: 动脉瘤, 夹层, 体外循环, 血小板计数, 滚压泵, 离心泵

Abstract: Objective To compare the effect of centrifugal pump and roller pump on platelet in Stanford A-type aortic dissection under cardiopulmonary bypass (CPB). Methods A total of 40 patients who planned to undergo a surgery were enrolled, and they were divided into the centrifugal pump group (n=20) and the roller pump group (n=20) according to the random number table. Data of CPB time, aortic cross-clamp time, circulatory arrest time, blood consumption, coagulation function, liver and kidney function, blood routine, postoperative chest drainage, mechanical ventilation time, ICU (intensive care unit) length of stay, length of hospital stay, and complications were recorded in the two groups. Platelet α -granule membrane protein 140 (GMP-140) and platelet factor 4 (PF4) concentration and platelet count were detected after induction of anesthesia (T1), 0.5 h after fish sperm neutralization (T2), 4 h in ICU (T3), 24 h in ICU (T4), and 48 h in ICU (T5). Results There were no significant differences in baseline data and intraoperative indicators (CPB time, aortic cross-clamp time, circulatory arrest time, blood consumption, bleeding volume) between the two groups (P＞0.05). At T2-T4, compared with the roller pump group, platelet count was increased, and the concentration of PF4 and GMP140 decreased in the centrifugal pump. At 4 h and 24 h, the chest drainage and blood consumption were significantly less in the centrifugal pump group than those in the roller pump group (P＜0.05). There were no significant differences in mechanical ventilation time, ICU stay time, length of hospital stay, 48 h chest drainage and complications between the two groups (P＞0.05). Conclusion In the operation of Stanford type A aortic dissection, the centrifugal pump can reduce platelet activation and consumption, and reduce postoperative bleeding and blood consumption.

Key words: aneurysm, dissecting, extracorporeal circulation, platelet count, roller pump, centrifugal pump

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