抑肽酶血液麻醉在脊柱外科手术中的应用  

Blood anesthesia with aprotinin in vertebral column surgery

作　　者：鲁开智[1] 王秀琼[1] 温荟琳[1] 易斌[1] 崔剑[1] 曹剑[1] 顾健腾[1] 陶国才[1] 

机构地区：[1]第三军医大学附属西南医院麻醉科,重庆市400038

出　　处：《临床麻醉学杂志》2005年第3期159-161,共3页Journal of Clinical Anesthesiology

摘　　要：目的　探讨抑肽酶血液麻醉在脊柱外科手术中的使用价值及对凝血功能的影响。方 法　60例择期行骨科脊柱手术患者,随机分为两组。观察组(A组,30例)在麻醉诱导后静注抑肽酶 200万kIU后持续泵注抑肽酶50万kIU/h,直至手术结束后停药;对照组(B组,30例)持续泵注生 理盐水。分别在术前、术毕、术后6h和24h时间点上抽血检测血常规、血栓弹性描记图(TEG)、凝 血功能指标。比较两组患者的出血量、输血量及TEG和凝血功能变化。结果　在使用了抑肽酶之 后,手术时间明显缩短;两组手术出血量及输异体血量比较,差异有极显著意义(P<0.01)。抑肽酶 对A组的纤维蛋白原(Fib)、TEG指标无显著影响(P>0.05)。结论　抑肽酶血液麻醉可明显减少 脊柱外科手术的出血量,减少异体血的输入,且不影响凝血功能。Objective To investigate the role of blood anesthesia with aprotinin during the vertebral column surgery and the effect on the blood coagulative function. Methods Patients undergoing vertebral column surgery were randomly divided into two groups with 30 cases each. Experiment group (group A) was injected with 200 pan-kIU aprotinin and pumped with 50pan-kIU/h until operation finished. The control group (group B) was treated with 0.9% normal saline. The venous blood was withdrawal for blood routine, thrombelastography (TEG) and coagulable function before operation,at the end of surgery,at 6 and 12 h after operation. The changes of TEG and coagulable state were monitored during the whole surgery. The volume of transfusion and hemorrhage of two groups was recorded and compared. Results The duration of operation was shorter obviously in group A than in group B. So did the volumes of hemorrhage and transfusion. Aprotinin did not influence the Fib and TEG of group A.Conclusion Aprotinin can reduce the volumes of hemorrhage and transfusion and has no influence on the coagulation function.

关 键 词：抑肽酶 血液麻醉 脊柱外科手术 血栓弹性描记图 

分 类 号：R614[医药卫生—麻醉学]