摘要
目的总结心脏手术应用鱼精蛋白中和肝素所致严重循环抑制病例的救治经验。方法回顾本中心2015年1月至2017年10月间,心脏手术中输注鱼精蛋白中和肝素后出现严重循环抑制的病例资料,分析其临床特点及发生鱼精蛋白毒性反应的影响因素。结果共有5例患者在术中出现了严重的循环抑制,都发生于输注鱼精蛋白后15~25(19.2)min;其中2例经心脏按摩和血管活性药的应用后好转,3例重新肝素化后建立体外膜肺氧合辅助循环。全组5例患者全部抢救成功。结论鱼精蛋白过敏反应所导致的严重循环抑制为突发事件且往往危及生命,必要的预防和及时有效处理是成功挽救患者生命的关键。
Objective To summarize clinical experience with the management of circulatory collapse after protamine injection during open heart operation under cardiopulmonary bypass. Methods Clinical data of patients with circulatory collapse after protamine injection from January 2015 to October 2017 were obtained and analyzed. Results Fives cases of circulatory collapse occurred at 15 to 25 min after protamine was given（ mean 19.2 min） during open heart operations. Two cases became stable after immediatecardiac massage and injection of vasoactive medicine while the other four received re-heparinization and re-extracorporeal circulation. All the patients were saved. Conclusion Circulatory collapse induced by protamine cannot be predicted. Prophylaxis and effective management are important to save life.
作者
叶家欣
徐航
熊剑秋
骆璇
陈杨
葛敏
王东进
Ye Jiaxin;Xu Hang;Xiong Jianqiu;Chen Yang;Ge Min;Wang Dongjin(Department of Cardiothoracic Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China)
出处
《中国体外循环杂志》
2018年第2期104-106,共3页
Chinese Journal of Extracorporeal Circulation
基金
南京市卫生科技项目医药项目(YKK15071)
南京市卫生青年人才计划项目(QRX17131)
关键词
鱼精蛋白
体外循环
体外膜肺氧合
心内直视手术
Protamine
Cardiopulmonary bypass
Extracorporeal membrane oxygenation
Open heart operation
