摘要
目的 :探讨采用小剂量抑肽酶应用于心内直视手术的止血效果。方法 :选择心脏瓣膜置换手术患者 30例 ;随机分为研究组 (小剂量组 ) 15例和对照组 (大剂量组 ) 15例。研究组放血结束后静脉滴注抑肽酶 10 0万kIU ,体外循环预充液中加入抑肽酶 10 0万kIU ,停机后持续静脉输入抑肽酶 5 0万kIU至术毕 ;对照组于相同时间分别给予抑肽酶 2 0 0万kIU、2 0 0万kIU和10 0万kIU。结果 :小剂量抑肽酶能明显减少术后出血 ,且术后 2 4h胸腔引流量 (34 5 .9± 16 2 .3ml)较对照组 (5 2 9.0±131.9ml)减少 35 % ;肝素化后和鱼精蛋白拮抗后 ,对照组ACT均显示延长 (P <0 .0 5～P <0 .0 0 1)。其它各观察指标均无明显变化 (P >0 .0 5 )。结论 :小剂量抑肽酶和大剂量抑肽酶一样能明显减少体外循环心内直视手术的出血量 ,具有止血效果明显和节约用药成本的优点。
Objective:To observe the haemostatic effect of low dose aprotinin during cardiopulmonary bypass(CPB). Methods:Thirty patients scheduled for elective valve surgery were randomly divided into two groups:High dose aprotinin group(control group,CG) and low dose aprotinin group(research group,RG). Following hemodilution,in RG,a bolus of 1.0×10 4 kIU aprotinin was administered intravenously after anesthesia induction,the same dose of aprotinin was added to the priming liquid of oxygentor and 0.5×10 4 kIU aprotinin was transfused after CPB. In CG,the double dose of aprotinin was given at the same time point as in RG. Results:Administration of low dose aprotinin reduced postoperative blood loss. During first 24 h after the operation,the chest drainage of RG(345.9±162.3 ml) was less than that of CG by 35%(529.0±131.9 ml). Active coagulant time of blood was prolonged obviously at post heparinize and after anti heparin,there was no other obvious change. Conclusions:Compared with high dose aprotinin,low dose aprotinin can reduce the postoperative bleeding in patients of CPB similarly. There is advantage of economizing medicine. [
出处
《蚌埠医学院学报》
CAS
2000年第4期244-245,共2页
Journal of Bengbu Medical College
