نوع مقاله : مروری

نویسندگان

1 بخش جراحی قلب باز بیمارستان امام رضا دانشگاه علوم پزشکی مشهد، مشهد، ایران

2 بخش بیهوشی بیمارستان امام رضا، دانشگاه علوم پزشکی مشهد، مشهد، ایران

3 مرکز تحقیقات جراحی سرطان دانشگاه علوم پزشکی مشهد، مشهد، ایران

چکیده

زمینه و هدف  روش جراحی گرفت بای‌پس سرخ‌رگ کرونر(CABG)  انتخابی بسیارخوب در درمان انسداد شریان کرونری قلب می‌باشد. از عوارض شایع CABG، خون‌ریزی‌های شریانی بر اثر پارگی بخیه‌ها در محل آناستوموز ایجاد می‌شود که بسیار خطرناک است. چسب فیبرینی (FG)، نوعی چسب بافتی است که نقش بسیار مؤثری در تسریع ترمیم زخم ایفا می‌کند. در حال حاضر، در عمل  CABGدر اکثر مراکز جراحی قلب باز FG استفاده نمی‌گردد. هدف این مقاله مروری، معرفی کارایی انواع FG در جلوگیری از خونریزی در محل آناستوموز CABG می‌باشد.
روش کار یک جستجوی نظام‌مند در PubMed از سال‌های 1999 تا 2019 با کلیدواژه‌های FG ،CABG و جراحی انجام گرفت. تمام مطالعات که به زبان انگلیسی و در ارتباط با خونریزی در محل آناستوموز بود، در نظر گرفته شد.
یافته‌ها 70 عنوان مقاله یافت شد که 17 مقاله، مورد استفاده قرار گرفتند. در مطالعات کارآزمایی بالینی، 11 مطالعه FG آلوژنیک تجاری؛ در 1 مطالعه، FG آلوژنیک از یک دهنده؛ در 3 مطالعه، FG اتولوگ؛ و 1 مطالعه، هم FG اتولوک و هم FG آلوژنیک تجاری؛ و در1 مطالعه حیوانی، FG اتولوگ و تجاری استفاده شده بود.14  مطالعه نشان دادند که FG تجاری یا اتولوگ در کاهش خونریزی مؤثرند. یک مطالعه نشان داد که FG اتولوگ در مقایسه با FG تجاری در کاهش خونریزی بهتر عمل می‌کند. یک مطالعه، هیچ اثری از FG در کاهش خونریزی مشاهده نکرد. یک مطالعه، تأثیرات بسیار منفی FG تجاری که باعث مرگ‌ومیر بیماران شده بود را گزارش کرد.
نتیجه‌گیری استفاده از FG آلوژنیک و اتولوگ، برای کاهش خونریزی‌های محل آناستوموز CABG بسیار مؤثر است.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Application of Platelet-Rich-Plasma Fibrin-Glue in Preventing of Bleeding in Coronary Artery Bypass Grafting, Review Article

نویسندگان [English]

  • Mohamad Abbasi Tashnizi 1
  • Mehdi Fathi 2
  • Farhood Sadralsadat 2
  • Omid Javedanfar 1
  • Daryoush Hamidi Alamdari 3

1 Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, IR

2 Department of anesthesiology, Faculty of medicine, Mashhad medical university of medical sciences, Mashhad, Iran

3 Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

چکیده [English]

Introduction: Coronary artery bypass graft (CABG) is a very good option for the treatment of coronary artery occlusion. One of the risks is bleeding from anastomotic site because of suturing disruption which is dangerous for patient. Fibrin glue (FG) is an effective tissue sealant in tissue repair. In the present time, FG has been not used routinely in CABG surgery. The aim of this review article is to evaluate the preventive effect of FG from bleeding in anastomotic site in CABG.
Materials and Methods: A systematic search in PubMed database was done from February 1999 to February 2019 with these key words: Fibrin glue, surgery and coronary artery bypass. All clinical and experimental studies, which are written in English language and about preventive effect of FG from bleeding in CABG surgery were considered.
Results: The seventy articles were found. Seventeen articles have been used. In Clinical studies, commercial allogenic FG in eleven studies , allogenic FG from single donor in one study, autologous FG in three studies and commercial allogenic & autologous FG in one experimental study were used. Fourteen studies showed that FG is very effective to decrease the bleeding. One study reported that autologous FG can decrease the bleeding better than commercial allogenic FG. One study reported no beneficial effect of FG in decreasing of bleeding. One study reported very adverse effect of FG which caused the mortality in patients.
Conclusion: The use of allogenic and autologous FG is very effective in reducing of bleeding in anastamotic site in CABG. 

کلیدواژه‌ها [English]

  • coronary artery bypass grafting
  • “fibrin glue”
  • "Surgery"
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