氨甲苯酸和抑肽酶对体外循环中肝素抗凝作用的影响  

The Influence of P aminomethyl Benzoic Acid and Aprotinin on the Anticoagulatory Effect of Heparin During Cardiopulmonary Bypass

作　　者：叶晓青[1,2] 毕叔同[1,2] 黄小蝶[1,2] 邓硕曾 

机构地区：[1]广东省深圳市孙逸仙心血管医院麻醉科 [2]北京阜外心血管病医院麻醉科

出　　处：《中国胸心血管外科临床杂志》1997年第2期92-94,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的为探讨氨甲苯酸和抑肽酶的止血疗效。方法将３４例成人心脏手术患者分为３组，Ａ组于体外循环（ＣＰＢ）前、中、后给予氨甲苯酸共７５０ｍｇ；Ｂ组ＣＰＢ中给予抑肽酶２００万Ｕ；并设一对照组。结果氨甲苯酸使ＣＰＢ中激活全血凝固时间（ＡＣＴ）明显缩短，追加肝素量较另两组显著增加（Ｐ＜０．０５），２４小时胸液量较对照组减少２３％（Ｐ＞０．０５）。抑肽酶使ＣＰＢ中ＡＣＴ略延长，与对照组相比无统计学意义，对肝素用量无影响，２４小时胸液减少３５％（Ｐ＜０．０５）。两用药组术中术后库血用量均显著减少（Ｐ＜０．０１），术后胸液量相似（Ｐ＞０．０５）。结论氨甲苯酸止血疗效弱并缩短ＡＣＴ及明显增加肝素用量，不如抑肽酶疗效可靠。Objective To study the hemostatic effect of P aminomethyl benzoic acid(PAMBA) and aprotinin in patients undergoing cardiopulmonary bypass(CPB). Methods 34 adult patients were randomized into three groups, 11 patients received 250mg PAMBA before, during and after CPB respectively, 12 patients received 2×10 6 U aprotinin in pump prime and 11 controls. Results In the PAMBA group, activated clotting time (ACT) was significantly decreased and heparin requirements( P <0.05) were significantly increased in comparison to the other groups, meanwhile the first 24 hour chest tube drainage was reduced 23%( P >0.05) than the control group. In the aprotinin group, ACT was slightly prolonged but both ACT and heparin requirements showed no significant differences than the control group. The first 24 hour chest tube drainage was reduced 35%( P <0.05)than the control group. The first 24 hour drainage had no significant differences between the PAMBA group and the aprotinin group. The use of homologous blood were significantly lower in both the two groups than the control group. Conclusion PAMBA had a less hemostatic effect with shortening ACT and increasing heparin requirements. Thus, the use of PAMBA was not as effective and save as use of aprotinin during CPB.

关 键 词：体外循环 氨甲苯酸 抑肽酶 肝素 抗凝作用 

分 类 号：R654.1[医药卫生—外科学]