体外循环心脏术后抗凝血酶活性与手术不良结果的相关性  

Postoperative antithrombin levels and adverse outcome in cardiac operations

作　　者：王红兵[1] 单飞[1] 崔勤[1] 胡晓[1] 刘松涛[1] 

机构地区：[1]第四军医大学西京医院心血管外科,陕西西安710032

出　　处：《心脏杂志》2006年第6期682-684,共3页Chinese Heart Journal

摘　　要：目的观察患者回到ICU后的抗凝血酶活性以及术后各种不良结果的联系。方法2005年3月至5月在我科接受体外循环心脏手术的237例患者。分别测定术前、术后的抗凝血酶活性,并观察分析其与术后不良效应的相关性。结果术后抗凝血酶活性较术前显著降低(P<0.01)。分析发现术后抗凝血酶的低活性与胸引量增多,机械通气时间延长以及ICU的天数,输血量增加,二次开胸,低心排,神经系统并发症,血栓栓塞,肾功能不全等明显相关。结论ICU内患者抗凝血酶的低活性与心脏术后的预后不良相关;并且可以预示患者在ICU的时间将会延长。AIM To investigate the association between antithrombin activity at admission to the ICU （ICU-antithrombin activity） and various outcome variables. METHODS The subjects included in this study were 237 consecutive patients who had undergone cardiac surgery with cardiopulmonary bypass at our department. The antithrombin activity was measured pre and post operation and the association with outcome in cardiac surgery was observed. RESULTS ICU-antithrombin activity significantly （P 〈 0.01 ） decreased when compared with preoperative values. The statistics showed that low levels of ICU- antithrombin activity were significantly associated with higher blood loss, prolonged mechanical ventilation time and ICU stay, a higher incidence of allogeneic blood products use, surgical reexploration, low cardiac output syndrome, adverse neurologic events, thromboembolic events, and renal dysfunction. CONCLUSION Low levels of ICU-antithrombin activity are associated with a poor outcome in cardiac surgery. ICU-antithrombin activity is predictive of prolonged ICU stay.

关 键 词：抗凝血酶 体外循环 心脏手术 并发症 

分 类 号：R651.11[医药卫生—外科学]