使用氨甲苯酸减少体外循环后出血的初步观察

Reduction of Post Cardiopulmonary Bypass Bleeding with PAMBA

任选瓣膜替换术100例、随机分为研究组(氨甲苯酸)和对照组各50例。麻醉后均从右颈内静脉插管放自体血10ml/kg,于体外循环后输回病人。研究组放血后静注氨甲苯酸(PAMBA)250mg。体外循环预充液中加入PAMBA250mg。用鱼精蛋白中和肝素后再静注PAMBA250mg。结果氯甲苯酸组术后24h胸腔平均失血量仅为213±133ml,较对照组530±352ml减少60％(P<0.01)。结果提示使用PAMBA可减少体外循环后出血而未见血栓形成及任何不良反应。

One hundred cases of valvular replacement were randomly divided into observed group and control group with 50 cases each. All patients were removed autogenous blood in a ratio of 10ml/kg via the right internal jugular vein catheter after anesthesia and infused them back following cardiopulmonary bypass (CPB). In the observed group p-aminomethyl benzoie acid(PAMBA) was administered intravenously for each patient as following steps; the first 250mg was given after blood removal , the second 250mg was added in the priming fluid of extra-corporeal circulation and the third same dose was given while the heparin was neutralized with protamin. It was found that the mean blood lose in this group was only 213± 133ml within 24 hour postoperativly, which was significantly lower than that in the control group 530 ± 352ml. The preliminary result suggests that PAMBA used in CPB may decrease bleeding by about 60% without any adverse reaction such as thrombosis.