乌司他丁加氨甲环酸与抑肽酶对体外循环的作用  

Study on the Effects of Ulinastatin Plus Tranexamic Acid and Aprotinin on Cardiopulmonary Bypass

作　　者：武婷[1] 文其祥[1] 

机构地区：[1]天津市胸科医院,300051

出　　处：《天津医药》2005年第12期767-769,共3页Tianjin Medical Journal

摘　　要：目的:对比乌司他丁(U)加氨甲环酸(TA)与抑肽酶(AP)对体外循环的影响。方法:选取体外循环心脏手术成年患者97例,其中瓣膜置换45例,冠脉旁路移植31例,2种手术混合21例,随机分为U+TA组、AP组和对照组。U+TA组除常规用药外,于切皮前及体外循环并体后2个时间点各静脉推注0.75gTA,U则在并体后于氧合器内一次性注入1×106IU;AP组在常规用药的基础上同TA两个时间点各持续滴注AP25×105IU;对照组常规用药。于术前、术后分别测定血小板数量与功能、平均血小板体积、凝血3项和D-二聚体,记录各组术中出血量、术后12h,24h纵隔心包引流量、术后输血量、拔气管插管时间及ICU时间。结果:AP组和U+TA组术后血小板数量和功能、D-二聚体值、引流量、输血量、拔气管插管时间、ICU时间与对照组差别均有统计学意义(P<0.05),而AP组与U+TA组之间差别无统计学意义。结论:乌司他丁加氨甲环酸具有近似于抑肽酶的功能作用。Objective： To study the effects of ulinastatin （U） plus tranexamic acid （TA） and aprotinin （AP） on cardiopulmonary bypass （CPB）. Methods： Ninety-seven adult CPB patients including 45 valve replacements, 31 coronary revascularisations and 21 mixed were randomly divided into U＋TA, AP and control groups. 0.75 gTA was injected before skin incision and after CPB in U＋TA group, 1×10^6 IU U was injected after CPB in U＋TA group; 25×10^5 IU AP was continuous injected before skin incision and after CPB in AP group, no drugs were used in control group. The platelet count, MPV, PAdT, PT, AFFF, FIB, D-dimers were evaluated before and after operation, the intraoperative blood loss, the postoperative mediastinal chest tube drainage （MCTD） during the 12 and the 24 hours, the postoperative blood product transfusions, trachea tube time and the ICU time were all recorded. Results： Platelet count, PAdT, D-dimer, postoperative MCTD, transfusion, trachea tube time and ICU time were significantly different between AP group, U＋TA group and control group （P 〈 0.05）. There was no significant difference between AP group and U＋TA group. Conclusion： Ulinastatin plus tranexamic acid is as effective as aprotinin undergoing cardiac surgery with CPB.

关 键 词：糖蛋白类 氨甲环酸 抑肽酶 体外循环 

分 类 号：R654.2[医药卫生—外科学] R654.1[医药卫生—临床医学]