体外循环开心手术中小剂量抑肽酶止血效果探讨

Effect of low dose aprotinin on reduction of blood loss during and after cardiopulmonary bypass

目的 :探讨小剂量抑肽酶在体外循环开心手术中的止血效果 ,方法 :选择 2 2例成人开心手术患者 ,随机分为两组。抑肽梅组从麻醉诱导开始到手术终 ,15 0万U～ 2 0 0万U抑肽酶被静脉滴注或混入预充液中 ,对照组不使用抑肽酶。观察两组术中、术后血凝纤溶系统的变化及手术时间、止血时间和出血量的变化。结果 :抑肽酶组 ,α2 明显增高 ,PIC ,D Dimer明显降低 ,表明纤溶系统被抑制。抑肽酶组手术时间、止血时间较对照组缩短 ,但术后出血量、输血量两组间无明显差异。结论

Objective:Evaluated the effect of low dose aprotinin on reduction of blood loss and the function on the coagulation and the fibrinolytic system during and after cardiopulmonary bypass(CPB).Methods:22 adult patients under going open heart surgery under CPB were divided in to two groups:aprotinin group and non-aprotinin group.In the aprotinin group,1 500 000～2 000 000 units of aprotinin was infused intravenously or mixed with priming volume of CPB from anesthetic guide until the end of the operation.The coagulation and fibrinolytis system was measured and compared with non-aprotinin group.Results:The aprotinin group showed a significantly enhanced level of α 2 plasmin inhibitor and a significanted reduced level of plasmin-α 2 plasmin inhititor complex and D-Dimer.Operation time and closure time after heparinneutralization was shorter,but postoperation blood loss and blood transfusion was non different between tow groups.Conclusion:The administration of low dose aprotinin suppresses the fibrinolytic system resulting in the reduction of oper ation and closure time ,not to reduce significantly the blood loss.