富血小板血浆分离应用于体外循环心脏手术的研究进展
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摘要
体外循环下的心脏手术术后易发生严重出血,往往需要血制品的输入,但是血制品资源有限,并且输注血制品成本较高,还伴随相应的不良反应。所以,近年来越来越多的研究应用富血小板血浆分离技术于此类手术,以达到减少体外循环对血液的破坏,实现血液保护的目的。
Cardiac surgery with cardiopulmonary bypass is prone to severe bleeding and often requires blood product transfusion. However,blood products are limited,expensive,and can cause adverse reactions in recipients. Therefore,in recent years,increased research has been conducted on the use of platelet-rich plasmapheresis in such types of cardiac surgery,to reduce the destruction of the blood from cardiopulmonary bypass and to prevent blood loss.
Cardiac surgery with cardiopulmonary bypass is prone to severe bleeding and often requires blood product transfusion. However,blood products are limited,expensive,and can cause adverse reactions in recipients. Therefore,in recent years,increased research has been conducted on the use of platelet-rich plasmapheresis in such types of cardiac surgery,to reduce the destruction of the blood from cardiopulmonary bypass and to prevent blood loss.
引文
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[2]EDMUNDS LH.Managing fibrinolysis without aprotinin[J].Ann thorac Surg,2010,89(1):324-331.DOI:10.1016/j.athoracsur.2009.10.043.
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[8]魏海燕,史宏伟,鲍红光,等.急性血小板分离回输对体外循环心脏直视手术患者的血液保护效果[J].中华麻醉学杂志,2011,7(31):812-815.DOI:10.3760/cma.j.issn.0254-1416.2011.07.010.
[9]石晟,王古岩.术前自体血小板分离在心脏手术中的血液保护作用[J].中国分子心脏病学杂志,2015,2(15):1292-1294.
[10]LCHIKAWA J,OSADA Y,KODAKA M,et al.Association between platelet count and postoperative blood loss in patients undergoing cardiac surgery with cardiopulmonary bypass and fresh frozen plasma administration guided by thromboelastometry[J].Circ J,2018,3(82):677-683.DOI:10.1253/circj.CJ-17-0712.
[11]CROWTHER M,FORD I,JEFFREY RR,et al.Quality of harvested autologous platelets compared with stored donor platelets for use after cardiopulmonary bypass procedures[J].Br J Haematol,2000,111(1):175-181.DOI:10.1111/j.1365-2141.2000.02347.x.
[12]MAHONEY CB.Platelet-rich plasmapheresis:a meta-analysis of clinical outcomes and costs[J].J Extra Corpor Technol,1998,30(1):10-19.
[13]ZHOU SF,ESTRERA AL,MILLER CC,et al.Analysis of autologous platelet-rich plasma during ascending and transverse aortic arch surgery[J].Annthorac Surg,2013,95(5):1525-1530.DOI:10.1016/j.athoracsur.2012.09.054.
[14]SHORE-LESSERSON L,REICH DL,DEPERIO M,et al.Autologous platelet-rich plasmapheresis:risk versus benefit in repeat cardiac operations[J].Anesth Analg,1995,81(2):229-235.DOI:10.1097/00000539-199508000-00004.
[15]CARLESS PA,RUBENS FD,ANTHONY DM,et al.Platelet-rich-plasmapheresis for minimising peri-operative allogeneic blood transfusion[J].Cochrane Database Syst Rev,2011(3):Cd004172.DOI:10.1002/14651858.CD004172.pub2.
[16]RUBENS FD,FERGUSSON D,WELLS PS,et al.Platelet-rich plasmapheresis in cardiac surgery:a meta-analysis of the effect on transfusion requirements[J].J Thorac Cardiovasc Surg,1998,116(4):641-647.DOI:10.1016/S0022-5223(98)70172-2.
[17]EKBACK G,EDLUND B,SMOLOWICZ A,et al.The effects of platelet apheresis in total hip replacement surgery on platelet activation[J].Acta Anaesthesiol Scand,2002,46(1):68-73.
[18]赵嘉美,赵丽云,刘飒,等.自体富血小板血浆分离回输对主动脉手术患者血小板活化程度的影响[J].心肺血管病杂志,2016,12(35):962-966.DOI:10.3969/j.issn.1007-5062.2016.12.009.
[19]MURASE M,NAKAYAMA Y,SESSLER DI,et al.Changes in platelet Bax levels contribute to impaired platelet response to thrombin after cardiopulmonary bypass:prospective observational clinical and laboratory investigations[J].Br J Anaesth,2017,119(6):1118-1126.DOI:10.1093/bja/aex349.
[20]VAN VELZEN JF,LAROS-VAN GORKOM BA,POP GA,et al.Multicolor flow cytometry for evaluation of platelet surface antigens and activation markers[J].Thromb Res,2012,130(1):92-98.DOI:10.1016/j.thromres.2012.02.041.
[21]STOVER EP,SIEGEL LC,HOOD PA,et al.Platelet-rich plasma sequestration,with therapeutic platelet yields,reduces allogeneic transfusion in complex cardiac surgery[J].Anesth Analg,2000,90(3):509-516.DOI:10.1097/00000539-200003000-00002.
[22]WAJON P,GIBSON J,CALCROFT R,et al.Intraoperative plateletpheresis and autologous platelet gel do not reduce chest tube drainage or allogeneic blood transfusion after reoperative coronary artery bypass graft[J].Anesth Analg,2001,93(3):536-542.DOI:10.1097/00000539-200109000-00004.
[23]LI S,JI H,LIN J,et al.Combination of acute preoperative plateletpheresis,cell salvage,and aprotinin minimizes blood loss and requirement during cardiac surgery[J].J Extra Corpor Technol,2005,37(1):9.
[24]SATO H,YAMAMOTO K,KAKINUMA A,et al.Accelerated activation of the coagulation pathway during cardiopulmonary bypass in aortic replacement surgery:a prospective observational study[J].JCardiothorac Surg,2015,10:84.DOI:10.1186/s13019-015-0295-9.
[2]EDMUNDS LH.Managing fibrinolysis without aprotinin[J].Ann thorac Surg,2010,89(1):324-331.DOI:10.1016/j.athoracsur.2009.10.043.
[3]PAPARELLA D,ROTUNNO C,GUIDA P,et al.Hemostasis alterations in patients with acute aortic dissection[J].Ann Thorac Surg,2011,91(5):1364-1369.DOI:10.1016/j.athoracsur.2011.01.058.
[4]ZHOU SF,ESTRERA AL,LOUBSER P,et al.Autologous platelet-rich plasma reduces transfusions during ascending aortic arch repair:a prospective,randomized,controlled trial[J].Ann Thorac Surg,2015,99(4):1282-1290.DOI:10.1016/j.athoracsur.2014.11.007.
[5]VAN DER WAL MT,BOKS RH,WIJERS-HILLE MJ,et al.The effect of pre-operative blood withdrawal,with or without sequestration,on allogeneic blood product requirements[J].Perfusion,2015,30(8):643-649.DOI:10.1177/0267659115573097.
[6]RINDER CS,BOHNERT J,RINDER HM,et al.Platelet activation and aggregation during cardiopulmonary bypass[J].Anesthesiology,1991,75(3):388-393.DOI:10.1097/00000542-199109000-00002.
[7]KHURI SF,WOLFE JA,JOSA M,et al.Hematologic changes during and after cardiopulmonary bypass and their relationship to the bleeding time and nonsurgical blood loss[J].J Thorac Cardiovasc Surg,1992,104(1):94-107.
[8]魏海燕,史宏伟,鲍红光,等.急性血小板分离回输对体外循环心脏直视手术患者的血液保护效果[J].中华麻醉学杂志,2011,7(31):812-815.DOI:10.3760/cma.j.issn.0254-1416.2011.07.010.
[9]石晟,王古岩.术前自体血小板分离在心脏手术中的血液保护作用[J].中国分子心脏病学杂志,2015,2(15):1292-1294.
[10]LCHIKAWA J,OSADA Y,KODAKA M,et al.Association between platelet count and postoperative blood loss in patients undergoing cardiac surgery with cardiopulmonary bypass and fresh frozen plasma administration guided by thromboelastometry[J].Circ J,2018,3(82):677-683.DOI:10.1253/circj.CJ-17-0712.
[11]CROWTHER M,FORD I,JEFFREY RR,et al.Quality of harvested autologous platelets compared with stored donor platelets for use after cardiopulmonary bypass procedures[J].Br J Haematol,2000,111(1):175-181.DOI:10.1111/j.1365-2141.2000.02347.x.
[12]MAHONEY CB.Platelet-rich plasmapheresis:a meta-analysis of clinical outcomes and costs[J].J Extra Corpor Technol,1998,30(1):10-19.
[13]ZHOU SF,ESTRERA AL,MILLER CC,et al.Analysis of autologous platelet-rich plasma during ascending and transverse aortic arch surgery[J].Annthorac Surg,2013,95(5):1525-1530.DOI:10.1016/j.athoracsur.2012.09.054.
[14]SHORE-LESSERSON L,REICH DL,DEPERIO M,et al.Autologous platelet-rich plasmapheresis:risk versus benefit in repeat cardiac operations[J].Anesth Analg,1995,81(2):229-235.DOI:10.1097/00000539-199508000-00004.
[15]CARLESS PA,RUBENS FD,ANTHONY DM,et al.Platelet-rich-plasmapheresis for minimising peri-operative allogeneic blood transfusion[J].Cochrane Database Syst Rev,2011(3):Cd004172.DOI:10.1002/14651858.CD004172.pub2.
[16]RUBENS FD,FERGUSSON D,WELLS PS,et al.Platelet-rich plasmapheresis in cardiac surgery:a meta-analysis of the effect on transfusion requirements[J].J Thorac Cardiovasc Surg,1998,116(4):641-647.DOI:10.1016/S0022-5223(98)70172-2.
[17]EKBACK G,EDLUND B,SMOLOWICZ A,et al.The effects of platelet apheresis in total hip replacement surgery on platelet activation[J].Acta Anaesthesiol Scand,2002,46(1):68-73.
[18]赵嘉美,赵丽云,刘飒,等.自体富血小板血浆分离回输对主动脉手术患者血小板活化程度的影响[J].心肺血管病杂志,2016,12(35):962-966.DOI:10.3969/j.issn.1007-5062.2016.12.009.
[19]MURASE M,NAKAYAMA Y,SESSLER DI,et al.Changes in platelet Bax levels contribute to impaired platelet response to thrombin after cardiopulmonary bypass:prospective observational clinical and laboratory investigations[J].Br J Anaesth,2017,119(6):1118-1126.DOI:10.1093/bja/aex349.
[20]VAN VELZEN JF,LAROS-VAN GORKOM BA,POP GA,et al.Multicolor flow cytometry for evaluation of platelet surface antigens and activation markers[J].Thromb Res,2012,130(1):92-98.DOI:10.1016/j.thromres.2012.02.041.
[21]STOVER EP,SIEGEL LC,HOOD PA,et al.Platelet-rich plasma sequestration,with therapeutic platelet yields,reduces allogeneic transfusion in complex cardiac surgery[J].Anesth Analg,2000,90(3):509-516.DOI:10.1097/00000539-200003000-00002.
[22]WAJON P,GIBSON J,CALCROFT R,et al.Intraoperative plateletpheresis and autologous platelet gel do not reduce chest tube drainage or allogeneic blood transfusion after reoperative coronary artery bypass graft[J].Anesth Analg,2001,93(3):536-542.DOI:10.1097/00000539-200109000-00004.
[23]LI S,JI H,LIN J,et al.Combination of acute preoperative plateletpheresis,cell salvage,and aprotinin minimizes blood loss and requirement during cardiac surgery[J].J Extra Corpor Technol,2005,37(1):9.
[24]SATO H,YAMAMOTO K,KAKINUMA A,et al.Accelerated activation of the coagulation pathway during cardiopulmonary bypass in aortic replacement surgery:a prospective observational study[J].JCardiothorac Surg,2015,10:84.DOI:10.1186/s13019-015-0295-9.