摘要
目的:评估抗纤溶药物包括抑肽酶、6-氨基已酸和氨甲环酸在非体外循环冠脉搭桥术(OPCAB)中的血液保护作用。方法:70例OPCAB患者随机分为4组,分别接受半量抑肽酶(负荷剂量1×106kIU,术中5×105kIU/h维持),氨甲环酸(负荷剂量0.75g,术中250mg/h维持),6-氨基已酸(负荷剂量3.5g,术中1.5g/h维持)或等量生理盐水。记录围手术期出血量、输血情况、D-二聚体以及其他相关临床指标。结果:抑肽酶组、6-氨基已酸组和氨甲环酸组术后即刻及术后2hD-二聚体水平的升高均受到明显抑制,显著低于对照组水平。抑肽酶组术后2,6,24h及氨甲环酸组术后6,24h出血量均显著少于对照组;6-氨基已酸组术后出血量与对照组比较差别无统计学意义。4组患者早期临床结果相近。结论:初步证实在OPCAB应用抗纤溶药物是安全的。抑肽酶和氨甲环酸能有效地抑制纤溶亢进并减少术后出血量。6-氨基已酸可抑制术后纤溶亢进,但不能减少术后出血量。
Objective： The present preliminary study was designed to investigate the hemostatic effect of aprotinin, tranexamic acid （TA） and ε-aminocaproic acid （EACA） in off-pump coronary artery bypass （OPCAB）. Methods： Seventy patients undergoing elective OPCAB were randomized into four groups, received aprotinin, tranexamic acid, EACA and saline solution, respectively. Perioperative blood samples were collected. Hematologic and hemostasiologic parameters including D-dimer were analysed. Volume of blood loss, blood transfusion and other clinical data were recorded throughout the perioperative period. Results： Levels of D-dimer were significantly inhibited after surgery in all groups compared with that of control. Volume of blood loss was significantly reduced in the aprotinin and TA groups compared with that of control. Postoperative blood loss was similar between the EACA group and the control. Early clinical outcomes were similar among groups. Conclusion： The results indicated that aprotinin and tranexamic acid can be safely used in limiting fibrinolysis and reducing blood loss after OPCAB. EACA limited fibrinolysis, but failed to reduce postoperative blood loss.
出处
《天津医药》
CAS
北大核心
2006年第2期73-75,共3页
Tianjin Medical Journal
基金
天津市自然科学技术基金项目(项目编号:023617411)
天津市科技发展计划项目(合同编号:05YFSZSF02700)
