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Randomized Controlled Trial
. 2020 Dec 1;58(12):924-928.
doi: 10.3760/cma.j.cn112139-20191231-00647.

[Application of autologous platelet-rich plasma separation in cardiac valve replacement: a random clinical trial]

[Article in Chinese]
X Y Zhou  1 , L F Xu  1 , X Chang  1 , L Sun  1 , Z Guo  1
Affiliations
Randomized Controlled Trial

[Application of autologous platelet-rich plasma separation in cardiac valve replacement: a random clinical trial]

[Article in Chinese]
X Y Zhou et al. Zhonghua Wai Ke Za Zhi. .

Abstract
in English, Chinese

Objective: To examine the blood protective effect of autologous platelet-rich plasma separation for cardiac valve replacement under cardiopulmonary bypass. Methods: Sixty patients who underwent cardiac valve replacement under cardiopulmonary bypass from August 2018 to May 2019 in Shanghai Chest Hospital, Shanghai Jiao Tong University were randomly divided into control and treatment groups(each 30 cases). There were 33 males and 27 females, aged (52.0±8.4) years (range: 35 to 65 years). Autologous platelet separation was performed in the treatment group after anaesthesia administration and was completed before systemic heparinisation. Platelet separation was not performed in the control group. The thromboelastogram, blood routine, blood coagulation, perioperative fluid infusion, allogeneic blood transfusion, postoperative pleural fluid volume and postoperative fibrinogen were recorded before the operation, and 1 hour and 24 hours post operation. The two groups' data was compared by t test, Kruskal-Wallis test, Mann-Whitney U test or χ(2) test. Repeated measurement analysis of variance was used to compare platelet and coagulation indexes at different times. Results: The perioperative red blood cell transfusion of 0, 1~2, 3~4,>4 units with 6, 11, 1, 12 cases in treatment group and 14, 8, 6, 2 cases in control group (Z=-2.516, P=0.012). The postoperative fibrinogen of 0, 1, 2 units with 19, 2, 9 cases in treat group and 26, 2, 2 cases in control group (Z=-2.190, P=0.029). There was no significant difference in the cost of blood transfusion between the two groups during admission ((1 732±1 275) yuan vs. (1 176±941) yuan; t=-1.570, P=0.125). Conclusion: The use of autologous platelet-rich plasma separation can reduce the amount of allogeneic blood transfusion during valvular surgery under cardiopulmonary bypass.

目的： 探讨自体富血小板血浆分离技术在体外循环下心脏瓣膜置换手术中的血液保护作用。 方法： 2018年8月至2019年5月前瞻性纳入于上海交通大学附属胸科医院心外科拟行择期体外循环下心脏瓣膜置换术的60例患者，男性33例，女性27例，年龄（52.0±8.4）岁（范围：35~65岁）。随机分为对照组和实验组，各30例。实验组在麻醉诱导后全身肝素化前进行自体血小板分离，对照组不进行血小板分离操作。记录术前、术后1 h、术后24 h的血栓弹力图、血常规、凝血功能、围手术期液体输入量、异体输血量，术后胸腔引流量、纤维蛋白原使用量等。两组数据的比较采用t检验、Kruskal-Wallis检验、Mann-Whitney U检验或χ(2)检验，不同时间血小板及凝血指标的比较采用重复测量方差分析。 结果： 实验组和对照组围手术期异体红细胞输注量为0、1~2、3~4、>4单位的患者分别为6、11、1、12例和14、8、6、2例（Z=-2.516，P=0.012），纤维蛋白原输注量为0、1、2单位的患者分别为19、2、9例和26、2、2例（Z=-2.190，P=0.029）。两组患者入院期间输血费用差异无统计学意义[（1 732±1 275）元比（1 176±941）元，t=-1.570，P=0.125]。 结论： 体外循环下瓣膜手术中使用自体富血小板血浆分离技术可减少异体输血量。.

Keywords: Blood transfusion, autologous; Heart valve prosthesis implantation; Platelet-rich plasma.

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