Protective effect of autologous platelet-rich plasma in elderly patients with type A aortic dissection undergoing total arch replacement surgery / 中华老年医学杂志

ABSTRACT

Objective@#To assess the therapeutic effect and safety of autologous platelet-rich plasma(aPRP)in elderly patients undergoing total arch replacement surgery.@*Methods@#A total of 44 elderly patients aged 60 years and over undergoing total arch replacement surgery in our hospital from August 2015 to August 2018 were enrolled.Forty-four patients were divided into the control group without aPRP application(n=23)and the aPRP application group(n=21). Patients were followed up postoperatively, and preoperative and intraoperative data, postoperative mortality, the incidence of continuous renal replacement therapy(CRRT)and neurological complications were collected and statistically analyzed.@*Results@#Compared with the control group, the aPRP application group showed the transfusion volume of allogeneic red blood cell and fresh frozen plasma were significantly decreased in aPRP group[(69.1±138.3)ml vs.(803.6±433.6)ml, P<0.05]. The main indicators of blood coagulation function, postoperative hemoglobin and platelet count had no significant difference at 1h after the operation between the two groups(P>0.05). Postoperative drainage volume, hospital mortality, the duration of ventilatory support and duration of intermational components for unicode(ICU)stay had no statistical difference between the two groups(P>0.05). The average hospitalization days were shorter in the aPRP group than in the control group[(13.7±6.7)days vs.(16.9±11.4)days, P<0.05]. There was no statistical significance in the incidences of postoperative complications such as acute kidney injury, temporary neurological injury, stroke/cerebral hemorrhage, etc.between the two groups(P>0.05).@*Conclusions@#Preoperative aPRP application can significantly reduce intraoperative allogeneic blood transfusion volume, but has no significant effect on postoperative function of blood coagulation, reducing perioperative bleeding and complications, and the improvement of prognosis in elderly patients with type A aortic dissection undergoing total arch replacement surgery.