氨甲苯酸联合乌司他丁对小儿VSD修补术的临床效果

Clinical effect of aminomethylbenzoic acid combined with urinastatin on children with ventricular septal defect repair

目的比较氨甲苯酸单独使用与联合乌司他丁对小儿先心病室间隔缺损(VSD)修补术的血液保护效果。方法选择2012年2月至2015年3月于我院小儿心血管外科就诊并诊断为VSD的60例患儿进行回顾性分析,分为抑肽酶组(T组)、氨甲苯酸组(P组)和氨甲苯酸联合乌司他丁组(PU组),每组20例。三组患儿体外循环前给予不同药物预充液处理,记录所有患儿手术前后常规血液学指标、凝血功能指标,记录并比较术中出血量、术后输血量和术后6 h引流量。结果三组患儿术前、术后及组内术前、术后的PLT计数、血红蛋白和血细胞比容比较差异无统计学意义。三组患儿术前PT、APTT和FIB组间及组内术前、术后比较差异无统计学意义(P>0.05)。术后PU组PT显著低于T组和P组(P<0.05),APTT显著低于P组(P<0.05)。三组术后FIB比较差异无统计学意义(P>0.05)。PU组术中出血量显著低于T组和P组(P<0.05);三组术后输血量比较差异无统计学意义(P>0.05);术后6 h引流量PU组显著低于T组和P组(P<0.05)。结论在预充液中加入氨甲苯酸联合乌司他丁能更有效地对VSD修补术血液起到保护作用,可成为抑肽酶替代药物。

Objective To compare the protection effect of single use of aminomethylbenzoic acid and combi- nation use of aminomethylbenzoic acid and urinastatin on children with ventricular septal defect （VSD） repair for con- genital heart disease. Methods A total of 60 patients diagnosed with VSD of congenital heart disease in pediatric car- diovascular surgery of our hospital from February 2012 to March 2015 were analyzed retrospectively, and were divided into aprotinin group （ group T） , group of aminomethylbenzoic acid combined with ulinastain （ group PU） and aminom- ethylbenzoic acid group （ group P） ,20 cases in each group. The corresponding drug treatment was given before the ex- tracorporeal circulation. The routine hematology indexes and blood coagulation function indexes after surgery and the a- mount of intranperative blood loss, postoperative blood transfusion and 6 h postoperative drainage were recorded. Re- sults PLT counts, hemoglobin and blood cells volume of the three groups and in the same group before and after oper- ation had no significant difference （ P 〉 0. 05 ）. PT, APTT and FIB of the three groups before operation had no signifi- cant difference （ P 〉 0. 05 ）, and no obvious difference was found in the indexes in each group before and after operation （ P 〉 0. 05 ）. After operation, PT of group PU was significant lower than those of group T and group P （ P 〈 0. 05 ）, APTT was significant lower than that of group P （ P 〈 0. 05 ）. There was no significant difference in FIB and blood transfusion volume among the three groups before operation （ P 〉 0. 05 ） , while rainage of group PU was significant lower than those of group T and group P at 6 h before operation （ P 〈 0. 05 ）. Conclusion Aminomethylbenzoic acid combined with urinastatin in pre-liquid can effectively protect the blood in the VSD repair and can become one of the alternative medicines aprotinin.