止血芳酸对体外循环期间纤溶系统激活反应的影响

Inhibition of P-aminomthy benzonic acid on hyperfibrinolysis during cardiopulmonary bypass.

目的 研究止血芳酸对体外循环 (CPB)心脏手术中纤溶系统激活反应的影响。方法 6 0例择期CPB心脏手术患者 ,随机分为两组 (每组各 30例 ) ,止血芳酸组于CPB转流前、CPB预充液中以及鱼精蛋白中和后 1 0min ,经中心静脉分别给予止血芳酸 2 5 0mg ;对照组不给药。分别在麻醉诱导后切皮前、CPB后 30min、CPB停机及手术结束时检测血小板计数、D 二聚体、纤维蛋白 (原 )降解产物 (FDP)的含量。结果 转流后两组血小板计数均明显减少 ,止血芳酸组降低程度相对较轻 (P <0 .0 5 ) ;转流后两组的D 二聚体、FDP均显著增高 ,止血芳酸组与对照组比均明显降低 (P <0 .0 5或P <0 .0 1 )。

Objective To investigate the effect of P aminomthy benzonic acid (PAMBA) on hyperfibrinolysis during cardiac surgery with CPB.Methods Sixty patients undergoing selective cardiac surgery with CPB were randomly divided into two groups. In observation group (group A, n =30) PAMBA 250 mg was administered respectively prebypass, CPB primiing fluid and immediately 10 min after protamine neutralization, whereas in control group (group B, n =30) the medicine was not administered. The central venous blood samples were taken to measure the platelet count and the contents of D dimer, fibrinogen degradation product 30 min after CPB,after weaning from CPB and at the operative end respectivoely.Results The platelet counts were decreased obviously in both group A and B. The platelet count in group B was lesss than that in group A ( P < 0.05 ). The contents of D dimer and fibrinogen degradation product at post bypass were signifcantly higher than those atprebypass in both groups, whereas the contents of D dimer and fibrinogen degradation product at each time point in group A were signifcantly lower than those in group B ( P < 0.05 or P < 0.01 ).Conclusion The intravenous PAMBA may inhibit hyperfibrinolysis and indirectly protect the platelet function.