术前应用抑肽酶对脑膜瘤切除术患者术中出血量和术后脑水肿的影响  

Effect of Preoperative Aprotinin Infusion on Blood Loss and Brain Edema in Patients Undergoing Meningioma Resection

作　　者：王会文[1] 赵岩[1] 梁辉[1] 王保国[1] 韩如泉[1] 

机构地区：[1]中国医学科学院首都医科大学附属北京天坛医院麻醉科,北京市100050

出　　处：《中国康复理论与实践》2008年第9期864-865,共2页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的观察术前单次应用小剂量抑肽酶对脑膜瘤切除术患者术中出血量和术后脑水肿的影响。方法80例择期行脑膜瘤切除术患者分为对照组和抑肽酶组,每组40例。抑肽酶组以100 ml/h的速率于手术开始前持续输注抑肽酶×106KIU（溶于50 ml生理盐水中）。术后由术者对术中出凝血、止血情况进行评估分级,由放射科医师对患者术后24 h CT片进行脑水肿评级。结果两组一般情况、输液量、尿量、术后24 h脑水肿评级无显著性差异（P〉0.05）。抑肽酶组与对照组的手术时间分别是（209±63）min、（305±93）min,术中出血量分别是420（150～3270）ml、610（110～2430）ml,两组比较有显著性差异（P〈0.05）。术者对术中出凝血、止血情况分级两组间有显著性差异（P〈0.05）。结论脑膜瘤切除术患者术前应用抑肽酶200万KIU可以缩短手术时间,减少术中出血量,并使术野清晰,但不能有效减轻术后脑水肿。Objective To observe the effects of preoperative aprotinin infusion on blood loss and brain edema in patients undergoing meningioma resection. Methods 80 were randomized to receive intravenous normal saline （control group） or aprotinin 2.0 × 10^6 KIU （aprotinin group） before operation. The intraoperatively hemostatic appearance was assessed by the surgeon in the form of quantitative scoring. The postoperative degree of brain edema was assessed by radiologist according to the appearance of computer tomography. Results There were no statistic differences in general information, intraoperatively infused volume, urine volume, and the quantitative score of postoperatively brain edema （P〉0.05）. The operation duration was （209 ±63） min and （305± 93） min, blood loss was 420 （150-3270） ml and 610 （110-2430） ml in the aprotinin group and the control group respectively （P〈0. 05）. There was statistic difference in the score of intraoperatively hemostatic apperance （P〈0. 05）. Conclusion In the resection of meningeoma, aprotinin was infused with a dose of 2. 0×10^6 KIU preoperatively can shorten the duration of operation and reduce the intraoperative blood loss, hut it cannot relieve the degree of postoperatively brain edema.

关 键 词：抑肽酶 出血量 脑水肿 开颅手术 

分 类 号：R739.45[医药卫生—肿瘤]