Clinical Application Of Off-pump Coronary Artery Bypass Grafting(OPCABG)without Allogeneic Blood Transfusion

Objective Now a variety of blood conservation measures have been applied in clinical.Recycling type of autologous blood transfusion in off-pump coronary artery bypass grafting have a higher value.Washable autologous blood be infused may cause patient's blood coagulation dysfunction,affect the stability of the internal environment and increase bleeding postoperatively.The purpose of the study is to observe the clinical effect of perioperative simple transfusion of autologous blood in off-pump coronary artery bypass grafting(OPCABG).Methods Clinical data were retrospectively collected and analyzed from 132 patients who underwent OPCABG in our hospital between August 2015 to July 2016.The patients were divided into experimental group(no allogeneic blood transfusion group)and control group(allogeneic blood transfusion group)according to whether or not allogeneic blood inputed.Analysed of two groups with volume of autologous blood,the number of anastomotic vessels,the postoperative 24 hours ventricular pericardial drainage,perioperative ventilator-assisted ventilation time,aortic balloon pump(IABP)Use,postoperative hospital stay and hospital costs.The parameters such as hemoglobin(HGB),platelet(PLT),total bilirubin(TBIL),alanine aminotransferase(ALT),creatinine(CRE)and prothrombin time(PT)in experimental group were compared with control group at preoperative and 24 hours postoperatively.Observed the blood transfusion within 2h whether the body temperature rising,skin itching,urticaria and other blood transfusion reactions occurred.Results There was no significant difference between the experimental group and the control group in terms of age,weight,gender composition,old history of myocardial infarction,left ventricular ejection fraction and Gesini scores(P> 0.05).The perioperative ventilator-assisted ventilation time was 19.44 ± 4.60 h in the experimental group,the control group was 23.74 ± 8.42 h,P <0.001,the perioperative ventilator-assisted ventilation time in the experimental group was shorter than that in the control group.The cost of hospitalization was 11.12 ± 0.17 million in the experimental group,the control group was 12.22 ± 0.27 million,P <0.05,the perioperative hospitalization cost of the experimental group was lower than that in the control group.There were 3 cases of blood transfusion in the control group,and no transfusion reaction was found in the experimental group(P> 0.05).There was no significant difference between other indexs(P> 0.05).Conclusion The application of the technology can correct perioperative anemia and reduce allogeneic blood transfusion.It is important for saving allogeneic blood source.The patient's coagulation function and postoperative recovery of the patients with no obvious adverse effect.It can reduce the hospitalization expenses,avoid transfusion related complications.It can be applied in clinical.