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| Preventive Effect of Perioperative Hemoglobin and Prothrombin Time Monitoring on Reducing the Risk of Gastrointestinal Bleeding after Aortic Valve Replacement in Elderly Patients with Aortic Stenosis |
| WANG Xiao-jun, TAO Yue |
| Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 201700, China |
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Abstract 【Objective】To analyze the preventive effect of hemoglobin and prothrombin time monitoring on the risk of gastrointestinal bleeding after aortic valve replacement in elderly patients with aortic stenosis. 【Methods】A total of 76 patients with aortic stenosis who underwent aortic valve replacement in our hospital from May 2016 to September 2017 were enrolled in our hospital. Blood samples were collected from all selected patients at 12h (T0), intraoperative (T1), and 12h (T2) after surgery. Hemoglobin was sampled from whole blood and immediately detected after collection. The detection method was high-performance liquid chromatography. Prothrombin time (PT) was measured using a Sysmex CA-7000 automated hemagglutination analyzer. Statistical analysis of the resulting data was performed using software SPSS 16.0. 【Results】 The hemoglobin levels in the case group at T1 and T2 were significantly lower than those in the control group (P<0.05). The hemoglobin level at T1 was significantly lower than that at T0 (P<0.05). The hemoglobin level at T2 was significantly higher than that at T1 (P<0.05). The prothrombin time in the case group at T1 and T2 was significantly longer than that in the control group (P<0.05). The prothrombin time at T1 was significantly longer than that at T0 (P<0.05). Prothrombin time was significantly shorter than T1 (P<0.05). Patients with upper gastrointestinal hemorrhage had hemoglobin and prothrombin measured in three different periods: 12h (T0), intraoperative (T1), and 12h (T2). There was a negative correlation (P<0.05). There was a negative correlation between hemoglobin and prothrombin levels during the intraoperative (T1) period in patients without upper gastrointestinal hemorrhage (P<0.05), 12 h before surgery (T0), and 12 h after surgery (P<0.05). 【Conclusion】Perioperative hemoglobin and prothrombin time monitoring have a certain preventive effect on reducing the risk of gastrointestinal bleeding after aortic valve replacement in elderly patients with aortic stenosis. At the same time, patients with a focus on hemoglobin reduction and prothrombin time should be paid attention to during the detection process. Once the relevant postoperative complications occur, the cause and symptomatic treatment should be promptly performed.
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Received: 27 March 2019
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2019, Vol. 36 
