EFFECT OF PREOPERATIVE PLATELET SEPARATION AND REINFUSION ON BLOOD SAVING EFFECT, BLOOD FIBRINOLYTIC SYSTEM, BLOOD OXYGEN METABOLISM, PLATELET AND COAGULATION FUNCTION IN PATIENTS UNDERGOING HEART VALVE REPLACEMENT

Hengxiao Fang, Liushan Yang, Yi Jiang, Chunrong Mo, Lei Luo, Wangju Fan, Yue Fan_*

Department of Cardiothoracic Surgery, Ruikang Hospital Affiliated to Guang University of Chinese Medicine, Nanning, PR China

Objective: To analyse the effects of preoperative platelet separation and reinfusion on blood-saving effect, blood fibrinolytic system, blood oxygen metabolism and platelet coagulation in patients undergoing heart valve replacement.

Methods: A total of 86 patients with cardiac valve replacement admitted to the cardiac surgery department of our hospital from March 2015 to May 2018 were selected. Among them, 43 cases were in the observation group (underwent platelet separation and reinfusion) and 43 cases were in the control group (did not undergo platelet separation and reinfusion). The effects on postoperative blood-saving effect, blood fibrinolytic system, blood oxygen metabolism and platelet and coagulation function were compared between the two groups.

Results: The amount of allogeneic blood infusion in the observation group was significantly lower than that in the control group, and the difference was statistically significant (p<0.05). There was no statistically significant difference in other indicators between the two groups (p>.05). Before treatment, FDP, D-Dimer and CM-140 in the two groups showed no statistically significant difference (p>.05). After surgery, FDP, D-Dimer and CM-140 in the two groups were significantly higher than before treatment, and the observation group was significantly lower than the control group, with a statistically significant difference (p<.05). Compared with time point F1 in the observation group, DO2 at time point F3 in the control group decreased and ERO2 increased, with a statistically significant difference (p<.05). There was no significant difference in other indicators between the two groups (p>.05). Platelet count, fibrinogen, prothrombin time and thrombin time were significantly reduced in the two groups at 1 h after surgery (p<.05). The platelet count in the observation group was significantly higher than in the control group at 1 h after operation (p<.05). There was no significant difference between other indexes in the other time points of the observation group and the control group (p>.05).

Conclusion: During a heart valve replacement surgery, platelet separation and reinfusion can protect the blood coagulation system, reduce allogeneic blood input, avoid postoperative haemorrhage and improve platelet coagulation and the function of the blood fibrinolytic system. This procedure is worthy of clinical application.