Clinical Study And Significance Of Bloodless Surgery In Off-pump Coronary Artery Bypass Grafting

Objective: Bloodless cardiac surgery refers to avoid allogeneic blood in cardiac surgery input,improve the prognosis of patients with cardiac surgery and related professionals to participate in the perioperative treatment.At home and abroad in recent years,a lot of heart surgery center are actively explore bloodless surgical technique.This paper aimed at the differences between the experimental group and control group and experimental group compared to the effect evaluation of the significance of off-pump cabg(opcabg),summarize the experience of bloodless surgery.Methods: In September 2014-December 2015,according to the standard(in accordance with coronary artery bypass grafting in patients with coronary heart disease,no blood group and control group.Preoperative generally have no obvious differences between cardiac function NYHA grade I,always,there is no history of heart or chest surgery)in patients with a total of 57 cases,it is divided into experimental group(divided into ABC three groups)and the control group: according to the operation will be divided into: the experimental group(a total of 26 cases): group A(acute normovolemic hemodilution including 11cases)group B(acute hyper-volumic hemodilution including 9 cases)group C(acute non-isometric hemodilution including 6 cases);The control group(group D of pure blood recycling)a total of 31 cases.Analysis between groups within the patient's clinical indicators: preoperative patients in general(age,weight and whether merger of other organs serious illness),intraoperative(total operation time,intraoperative blood loss and blood consumption),postoperative(Mechanical ventilation time,ICU guardianship time,postoperative hospitalization days,flow and drainage tube time,whether bleeding reoperation,transfusion of blood or not,the degree of wound healing,whether with pulmonary infection,and other pa-rts of the infection.Results: 1 Two groups of patients with preoperative in general,no difference(P>0.05).One of group D patients due to the need of estab-lishing extracorporeal circulation,one of group D case of sternalosteomyelitis.All patients had no in-hospital death,low cardiac syndrome,respiratory system,central nervous system complications,perioperative myocardial infarction,secondary thoracotomy hemostatic,I/a healing of incision.2 Two groups of patients with postoperative total volume of drainage(P < 0.05)significant difference,(the experimental group significantly less than the control group)without blood transfusion rate was 84.6%,while the control group was 16.1%,which higher than experimental group(P < 0.05).Duration of drainage,ICU guardianship days,hospita-lization days and the days of the take out stitches incision,no blood group significantly shorter than the control group(P < 0.05)(table 2).While there is no significant difference of breathing machine auxiliary time between them,6h,24 h,3d,7d after operation,white blood cells,platelets,liver and kidney function,plasma protein,blood oxygen partial pressure,partial pressure of carbon dioxide,lactic acid,whole blood PH has no obvious difference(P>0.05),hemoglobin,hematocrit,hypersensitive c-reactive protein difference was statistically significant(P < 0.05)(table 3).A,B,C three groups of 6h,24 h,3d,7d after operation,hemoglobin,hematocrit,hypersensitive c-reactive protein has no obvious difference(P >0.05).Conclusions:1 Bloodless coronary artery bypass surgery can significantly improve the prognosis,can bring about remarkable economic and social benefits.2 No difference between the three types of blood dilution method,can be chosen in the clinic.