应用大剂量氨甲苯酸减少体外循环术后失血

Effect of PAMBA in Decreasing the Blood Loss after CPB

目的：探讨大剂量氨甲苯酸（ＰＡＭＢＡ）对减少成人心脏手术后出血的作用。方法：３３例心脏手术病例，随机分为观察组２２例，对照组１１例。观察组于体外循环前应用小剂量抑肽酶、大剂量ＰＡＭＢＡ并加强血液回输措施，对照组仅用抑肽酶。记录两组病例术后２４ｈ的出血量、输血量及手术前后血红蛋白的变化，并进行统计学分析。结果：观察组术后出血量及所需输血量均较对照组少（Ｐ＜００１）。两组病人手术前后血红蛋白比较无统计学差异（Ｐ＞００５）。结论：大剂量ＰＡＭＢＡ与小剂量抑肽酶合用。

Objective: To evaluate the effects of high dose PAMBA on open heart surgery. Methods: Thirty three adult open heart surgical patients were divided into two groups, high dose of PAMBA (40mg/kg) and low dose of aprotinin were administered intravenously in study group, while low dose of aprotinin was used in control group. Volume of blood drainage and transfusion after the procedure and perioperative hemoglobin level were observed. Results: The volume of blood drainage and transfusion in the study group decreased remarkably than that of control group ( P< 0 01). Perioperative blood hemoglobin concentration between two groups had no statistical meaning. Conclusion: As a method of blood conservation, high dose of PAMBA and low dose aprotinin can be used to decrease blood loss and transfusion efficiently.