抑肽酶治疗产科DIC后对出血和异体血需求的影响

Effect of aprotinin on hemorrhage、blood requirement after the treatment of obstetrics DIC

目的探讨产科DIC应用抑肽酶治疗后对各项凝血指标的影响和继续出血量、输血量的影响。方法25例产科DIC的患者随机分为抑肽酶组(A组):抑肽酶100 K IU加入250 ml生理盐水中静脉滴注;常规治疗组(B组):输入同量的生理盐水,其他抢救措施两组相同。观察两组患者继续失血量、新鲜冰冻血浆、异体红细胞输注量以及红细胞压积(HCT)、血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆纤维蛋白原含量(FIB)的变化。结果抑肽酶组平均继续失血量、异体红细胞和新鲜冰冻血浆的需要量较常规治疗组减少,PT、APTT、FIB、PLT恢复至正常的时间较对照组明显缩短(P<0.01)。结论抑肽酶能明显减少产科DIC患者平均继续失血量和异体红细胞、血浆的需要量,加快凝血系统各项指标恢复正常。

Objective To study the effect of aprotinin on hemorrhage, blood requirement and blood coagulative function after the treatment of obstetrics DIC. Methods 25 patients with obstetrics DIC were divided randomly into two groups： aprotinin group（ group A） and conventional group（ group B）. Group A：100 KIU aprotinin with 250 ml saline were infused. Group B：equal volume of saline were infused. Other salvage treatment was homology in two groups. The volume of blood loss, fresh blood plasma and allogenic RBC requirement, changes of Hb levels, hcmatocrit, platelet counts, prothrombin time , activated partial thromboplastinogen time （APTT） and plasma fibrinogen content were recorded and compared between two groups. Results The average blood loss, fresh blood plasma and allogenic RBC requirement in group A were significantly lower than group B （ P 〈 0.01 ）. The duration for PT,APTT,FIB,PLT resuming to normal in group A was shorter than group B. Conclusion Aprotinin used in obstetrics DIC can reduce hemorrhage and blood requirement. The： parameters of coagulative function resuming to normal are quicker when using aprotinin in obstetrics; DIC.