Effect Of Lipo-PGE1on Blood Coagulation And Fibrionlysis System To Cardiopulmonary Bypass Patient

Objective: To investigate the dynamic changes in the coagulation andfibrinolytic system during and after open heart surgery performed withcardiopulmonary bypass（CPB） and the effect of Lipo-PGE1on coagulationand fibrinolysis system during cardiopulmonary bypass.Methods:48patients with heart disease in institue of cardiovasculardisease of de first affiliated hospital of guangxi medical university from marchin2011to december in2011were collected randomly and divided into groupA（n=24）: used Lipo-PGE1and group B（n=24）:unused Lipo-PGE1.Towgroup,blood samples were taken from jugular vein to assay plateletcount（PLT）,plasma free Ca²⁺,prothrombin time（PT）, activated partialthromboplastin time（APTT）,Thrombintime（TT）,Fibrinogen（FIB）,D-Dimer（D-D） levels,Activated prothronmbin time （ACT）,Plasma protein（HB） andother indicators of change before skin incision（T₁）,10min after heparin neutralization by protamine （T₂）,immediately closed chest（T₃）,3h afteroperation （T₄） four time pionts,the amount of banked blood and24h aftermediastinal chest tube drainge was recorded.to observe and record the lowcardiac output,the second thoracotomy to stop bleeding or cardiac tamponadeand the incidence of transfuction complications.Results:1.PLT count measured in the T₃time point between the two groups, group Aincreased significantly（P<0.05）; Compared with the T₁time points, at each timepionts of PLT count，T₂、T₃、T₄decreased statistically（P<0.05）in the group A;Compared with the T₁time points, at each time point of PLT count，T₂、T₃、T₄decreased statistically（P<0.05）in the group B.2.APTT measured in the T₃, T₄time points between the two groups,group Ashortened significantly （P <0.05）; Compared with the time point T₁, time point ofAPTT，T₄shortened significantly（P<0.05）in the group A; Compared with the timepoint T₁, time point of APTT，T₂shortened significantly（P<0.05）in the group B;3.Compared with the time point T₁, at each time point of PT，T₂、T₃、T₄timepoints prolonged statistically（P<0.05）in the group A; Compared with the timepoint T₁, at each time point of PT，T₂、T₃、T₄prolonged statistically（P<0.05）in the group B.4.Compared with the time point T₁,at each time point of TT, T₃、T₄shortedstatistically（P<0.05）; Compared with the time point T₁,at each time point ofTT,T₂、T₃、T₄points shorted statistically（P<0.05）in the group B.5.FIB measured in the T₂、T₃、T₄time points between the two groups, group Aincreased significantly（P<0.05）; Compared with the time point T₁, at each timepoint of FIB，T₂、T₃time points reduced statistically（P<0.05）in the groupA.Compared with the time point T₁, at each time point of FIB,T₂、T₃、T₄point reduced statistically（P<0.05）in the group B.6.D-D measured in the T₄time point between the two groups, group Adecreased significantly（P<0.05）；Compared with the time point T₁, at each timepiont of D-D，T₂、T₃、T₄point increased statistically（P<0.05）in the group B;7.Compared with the time point T₁, at each time piont of HB decreasedstatistically（P<0.05）in the group A; Compared with the time point T₁, at each timepoint of HB decreased statistically（P<0.05）in the group B.8.24h plasma dosage were decreased statistically between the two groups（P<0.05）.Conclusion:3⁵ng/kg/min dose of Lipo-PGE1does not increase thedisorder of blood coagulation and fibrinolytic systems when in the treatmentof pulmonary hypertension after Cardiopulmonary bypass.