体外循环下先天性心脏病术后持续输注鱼精蛋白对肝素反跳的影响  

Influence of extra-dose protamine infusion on heparin rebound after cardiopulmonary bypass surgery of congenital heart disease

作　　者：孙瑞强[1] 薛玉良[2] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]泰达国际心血管病医院

出　　处：《天津医科大学学报》2010年第4期614-616,共3页Journal of Tianjin Medical University

摘　　要：目的:观察体外循环下小儿先天性心脏病术后持续输鱼精蛋白对肝素反跳的影响。方法:60例先天性心脏病患者随机分为两组,实验组(P组)在中和肝素后5 min至4 h内持续输注鱼精蛋白[0.4 mg/(kg.h)];对照组(C组)则输注等量的生理盐水。分别在中和肝素后2、4、6 h测量ACT(激活凝血时间),6 h内胸腔引流量,并记录24 h内输血次数。结果:C组中和肝素后2、4 h ACT时间均较中和后5 min测定值延长(P<0.05),P组在中和后2 h ACT明显低于C组(P<0.05),术后6 h出血量P组少于C组(P<0.05)。结论:常规剂量鱼精蛋白中和肝素后2～4 h ACT时间轻度延长,中和后连续输注一定量的鱼精蛋白可避免ACT时间延长,同时减少术后出血量。Objective: To observe the influence of extra-dose protamine infusion on heparin rebound after cardiopulmonary bypass surgery of congenital heart disease.Methods: 60 patients with congenital heart disease were divided randomly into two groups:P group(n=30)received continous protamine infusion from 5 minutes to 4 hours after the dose of neutralization;C group(n=30) received normal saline under the same condition.The ACT of 2 h,4 h,6 h after neutralized dose,the amount of bleeding and blood transfusion of 24 hours were recorded.Results: The 2 h and 4 h ACT values of C group were more than that of 5 min after neutralization(extra-dose protamine after neutralization)(P<0.05),the 2 h ACT values of P group were less than that of C group(P<0.05),and the blood loss during 6 h after neutralization of P group was less than that of C group(P<0.05).Conclusion: ACT values are higher at the 2 h and 4 h after routine dose protamine neutralizes heparin;extra-dose protamine can shorten the time of high ACT at 2 h and 4 h after neutralization,and reduce the blood loss during the 6 hours after neutralization.

关 键 词：鱼精蛋白 体外循环 肝素 激活凝血时间 

分 类 号：R[医药卫生]