摘要
目的评价氨甲环酸对体外循环成人先天性心脏患者的血液保护作用。方法纳入我院2015年6．12月择期体外循环先天性心脏病患者84例，男37例，女47例，年龄18～50岁，将患者用随机数字表分为两组：对照组（A组），35例；氨甲环酸组（B组），49例。麻醉诱导后试验组经静脉30rain输注氨甲环酸1g，然后以400mg／h的速率持续输注至术毕；对照组给予等容量生理盐水。两组分别于术前、术毕和拔出引流管时，取中心静脉血样，测定国际标准化比值（international normalized ratio，INR）、血小板计数（platelet，PLT）、血红蛋白（hemoglobin，Hb）。并于拔管后记录总的引流量、红细胞和血浆的使用情况。观察住院期间是否有死亡和并发症的情况。结果两组术前lib、PLT、INR及术后红细胞的使用差异无统计学意义（P〉0．05）。与A组比较，B组术毕及拔管后Hb、PLT、INR、胸腔引流量、血浆的使用率差异有统计学意义（P〈0．05），但拔管后两组间PLT差异无统计学意义（P〉O．05）。住院期间均未观察到死亡和术后并发症的发生。结论氨甲环酸对成人体外循环先天性心脏病患者具有血液保护作用。
Objective To evaluate the blood protective effect oftranexamic acid on cardiopulmonary bypass in adult congenital heart disease patients. Methods There were 84 patients （37 males, 47 females） with congenital heart disease undergoing extracorporeal circulation, aged from 18 to 50 years in iur hospital from June through December 2015. All patients were divided into two groups include a control group （group A） with 35 patients and a tranexamic acid group （group B） with 49 patients. After induction of anesthesia, the group B was given tranexamic acid 1 g, and then at rate of 400 mg/h continuous infusion till the end of operation. The group A was given equal volume of physiological saline. Before and after operation and withdrawing of the drainage, the levels of hemoglobin （Hb）, platelet （PLT） and international normalized ratio （INR） were tested by taking the central venous blood samples. Chest tube drainage volume, use of red blood cells and plasma after opera- tion were recorded. Results No statistical difference was found between the two groups in Hb, PLT, or INR before opera- tion and usage of blood after operation （P〉0.05）. Compared with the group A, postoperative chest tube drainage, the use of plasma were lower （P〈0.05） in the group B. There was a statistical difference between two groups in Hb, PLT, INR after operation, and withdrawing of the drainage （P〈0.05）, respectively, while no statistical difference in PLT at withdrawing of drainage was loud. No in-hospital mortality or postoperative complication occurred. Conclusion Tranexamic acid has protective effest on blood in adult patients with congenital heart disease undergoing cardiac surgery under cardiopulmonary bypass.
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2016年第12期1139-1141,共3页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
氨甲环酸
成人先天性心脏病
血液保护
Tranexamic acid
Adult congenital heart patients
Blood conservation
