氨甲环酸对心脏手术后出血量及并发症影响的对照研究

Effects of tranexamic acid on bleeding and complication after cardiac surgery: a control study

目的:观察氨甲环酸对心脏手术后出血量的影响。方法:根据临床停止使用抑肽酶的时间,将560例行心脏手术患者分为抑肽酶组(n=303)和氨甲环酸组(n=257),对两组术后失血量、二次开胸止血率、输血量、急性肾功能不全及低心排综合征发生率等进行比较。结果:术后24 h出血量氨甲环酸组为(578.5±386.0)ml,抑肽酶组为(629.3±366.7)ml,两组差异无统计学意义(P=0.111)。二次开胸止血率氨甲环酸组为3.9%,抑肽酶组为4.3%,两组差异无统计学意义(P=0.730)。术后红细胞需求量氨甲环酸组为(2.39±6.20)U,抑肽酶组为(2.08±4.92)U;血浆需求量氨甲环酸组为(1.58±4.85)100 ml,抑肽酶组为(1.67±4.88)100 ml;血小板需求量氨甲环酸组为(1.19±5.12)10 U,抑肽酶组为(1.51±5.29)10 U,两组差异均无统计学意义(分别P=0.149、0.355、0.797)。结论:心脏手术中应用氨甲环酸可有效减少术后出血量及血制品需求量,其效果与抑肽酶相似。

Objective： To investigate the influence of using tranexamic acid during cardiac surgery on reduce postoperative bleeding.Methods： A total of 560 cases were involved,of which 303 in aprotinin group and 257 in tranexamic acid group.Postoperative blood loss,rate of reoperation for excessive postoperative bleeding,transfusion requirements,rate of acute renal failure and low cardiac output syndrome were compared between the two groups.Results： There were no significance differences of postoperative blood loss[（578.5±386.0） ml vs（629.3±366.7） ml,P=0.111] and rate of reoperation for excessive postopearative bleeding（3.9% vs 4.3%,P=0.730） between two groupes.The requirements of red blood cell,plasma,platelets were（2.39±3.20） U,（1.58±4.85）100 ml,（1.19±5.12）10 U in tranexamic acid groupe while（2.08±4.92） U,（1.67±4.88）100 ml、（1.51±5.29）10 U in aprotinin groupe,also showing no significance differences（P=0.149,0.355,0.797）.Conclusions： Tranexamic acid is as effective as aprotinin to reduce postoperative bleeding,transfusion requirements during cardiac operation.