抑肽酶与术中回收式自体输血在脊柱手术的应用比较  

Comparison of aprotinin and intraoperative autotransfusion in spinal surgery

作　　者：赵宝生[1] 周愚[1] 易斌[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：《实用医学杂志》2006年第20期2354-2356,共3页The Journal of Practical Medicine

摘　　要：Objective To assess the value of aprotinin in spinal surgery compared with intraoperative autotransfusion.Methods Eighty-six ASA Ⅰ～Ⅱpatients undergoing elective spinal surgery were paired according to their sex and age.The paired patients were randomly assigned into either aprotinin group (group I,n=43 ) or autotransfusion group (groupⅡ,n=43).Anesthesia was maintained with N2O inhalation supplemented with intermittent iv boluses of fentanyl and vecuronium.Aprotinin was injected by a bolus of 2 million IU and maintained with 500 000 kIU/h in group I.In groupⅡ,shed blood was collected and treated for reinfusion before the end of the operation.Results In group Ⅰ,the blood loss was reduced by 45%compared with group Ⅱ(P< 0.05) and there was no significant differences in prothrombin time (PT),activated partial thromboplastin time (APTT),platelet count,FIB concentration and thromboelastography (TEG) parameters as compared with the preoperative baseline value.TEG showed that reaction time increased while platelet count,PT and APTT decreased significantly in group Ⅱ.Conclusion Aprotinin has no effect on coagulation function and it may reduce the blood loss compared with autotransfusion in spinal surgery.Objective To assess the value of aprotinin in spinal surgery compared with intraoperative autotransfusion. Methods Eighty-six ASA Ⅰ～Ⅱ patients undergoing elective spinal surgery were paired according to their sex and age. The paired patients were randomly assigned into either aprotinin group （group Ⅰ, n = 43） or autotransfusion group （group Ⅱ, n = 43）. Anesthesia was maintained with N2O inhalation supplemented with intermittent iv boluses of fentanyl and vecuronium. Aprotinin was injected by a bolus of 2 million IU and maintained with 500 000 kIU/h in group Ⅰ. In group Ⅱ, shed blood was collected and treated for reinfusion before the end of the operation, Results In group Ⅰ, the blood loss was reduced by 45% compared with group Ⅱ （P 〈 0.05） and there was no significant differences in prothrombin time （PT）, activated partial thromboplastin time （APTT）, platelet count, FIB concentration and thromboelastography （TEG） parameters as compared with the preoperative baseline value. TEG showed that reaction time increased while platelet count, PT and APTT decreased significantly in group Ⅱ. Conclusion Aprotinin has no effect on coagulation function and it may reduce the blood loss compared with autotransfusion in spinal surgery.

关 键 词：抑肽酶 输血 自体 脊柱手术 凝血功能 

分 类 号：R614[医药卫生—麻醉学]