摘要
目的 评价氨甲环酸（TA）在减少体外循环心脏手术后出血的效果.方法 2009年3月至2011年10月间接受体外循环心脏手术者160例,随机分为氨甲环酸组（TA组,80例）和对照组（80例）,在体外循环术中,TA组静脉注射TA,对照组注射等量的0.9%生理盐水.比较两组在肝素化前、鱼精蛋白中和肝素后和术后24h三个时间点血小板数量、凝血指标及血浆D-D二聚体水平,同时比较术后6h、24h纵隔心包引流量及术后输血量.结果 体外循环术后24h TA组的总失血量（250±117）ml,显著少于对照组的（840±353）ml,且术中、术后输血量TA组显著少于对照组.术后对照组的血浆D-D二聚体水平显著增加.而TA组的D-D二聚体水平无显著变化.结论 与对照组相比,TA可以发挥抗纤溶作用,并能够有效地降低体外循环术后出血.
Objective To evaluate the effect of tranexamic acid （TA）on reducing postoperative bleeding in open-heart operation. Methods The clinical data of 160 patients undergoing cardiopulmonary bypass operation from March 2010 to October 2011 in department of cardiac surgery were randomly divided into TA group（$0 cases）and control group （80 cases）. TA and O. 9% sodium chloride solution of same volume were injected in the operation respectively. Blood samples were collected at different time points in- cluding pre-heparinization, post-neutralization of heparin by protamine and 24 hours after the operation. Platelet count, coagulation indicators and D-dimer were examined. Mediastinal drainage and blood transfu- sion volume of each patient were recorded at 6 and 24 hours after operation. Results In 24 hours,postop- erative blood loss was significantly less in the TA group（250 ＋ l17ml）than that in the control group （840 ＋ 353 ml）. The intraoperative and postoperative blood transfusion in TA group was also significantly less than that in control group. After operation, the D-dimer levels in plasma were increased significantly in the control group,whereas no significant changes were observed in the TA group. Conclusion Compared with the control group, TA may play a role in anti-fibrinolytic effects and it appears to be effective in reduc- ing the postoperative blood loss.
出处
《临床外科杂志》
2012年第7期495-497,共3页
Journal of Clinical Surgery
基金
深圳市科技计划项目资助（1002027）
关键词
心脏直视手术
体外循环
氨甲环酸
术后出血
open-heart operation
cardiopulmonary bypass
tranexamic acid
postopera- tive bleeding
