To explore the effect of tirofiban infusion mode on the hemorrhage of patients after coronary endarterectomy (CE).

Sixty-nine patients who underwent CE operation in Beijing Anzhen Hospital, Capital Medical University from June 2020 to May 2021 were included. According to the different infusion methods of tirofiban, the patients were divided into two groups: the application of adjustable intravenous infusion device group (45 cases) and the application of amedrop group (24 cases). The former used the infusion device with scale (roller or pulley), and the latter used the precision amedrop for clinical treatment. The postoperative infusion speed of tirofiban, blood loss on the first, second and third day after surgery were recorded and analyzed, the results of four coagulation tests and troponin detection on the first day after surgery, and other indicators were compared between the two groups. The data were compared by independent sample t-test, rank sum test and chi-square test, and linear regression model was used to analyze the correlation between postoperative blood loss and coagulation indicators.

The blood loss on the first day and the second day after operation in the amedrop group were (472.6±233.6)mL and 215.0 (152.5, 300.0) mL respectively, which were lower than those in the adjustable intravenous infusion set group [(1 134.8±317.8)mL、480.0 (350.0, 600.0) mL], the differences were statistically significant(t=8.97, Z=-5.81; P<0.05). The activated partial thromboplastin time (APTT) on the first day after operation in the adjustable intravenous infusion set group was (33.3±0.4) s, which was higher than that in the amedrop group[ (29.5±3.1) s], the difference was statistically significant(Z=-4.66, P< 0.05). There was no significant difference in tirofiban infusion rate, postoperative troponin, prothrombin time, fibrinogen and D dimer between the two groups (P> 0.05). Linear regression analysis showed that there was a significant linear correlation between the blood loss on the first day and second day after operation and APTT on the first day after operation (R²= 0.77, 0.49; P<0.05).

The APTT and postoperative blood loss of CE patients after infusion of tirofiban with adjustable intravenous infusion device are significantly increased, while the infusion of tirofiban with amedrop can significantly improve perioperative safety of patients underwent CE.