体外循环围术期栓溶二聚体动态变化及抗纤溶药疗效的观察  

Changes of Plasma D-dimer and Efficacy of Antifibrinolytic Agents in Patients Undergoing Cardiopulmonary Bypass

作　　者：叶晓青[1,2] 黄小蝶[1,2] 毕叔同 邓硕曾[1,2] 

机构地区：[1]广东省深圳市孙逸仙心血管医院 [2]中国医学科学院中国协和医科大学

出　　处：《中国循环杂志》1998年第1期35-36,共2页Chinese Circulation Journal

摘　　要：目的：观察体外循环（ＣＰＢ）围术期栓溶二聚体动态变化及抗纤溶药的疗效。方法：３０例成人心脏手术患者分为３组。①抑肽酶组：ＣＰＢ中给抑肽酶２×１０６ｋＩＵ；②氨甲苯酸组：于ＣＰＢ前、中、后各给氨甲苯酸２５０ｍｇ；③对照组。于麻醉诱导后、给肝素１０分、ＣＰＢ５分、ＣＰＢ３０分、ＣＰＢ结束时、给鱼精蛋白后１０分及手术结束时测定血浆栓溶二聚体含量。结果：与对照组相比，抑肽酶组ＣＰＢ中栓溶二聚体值略降低，术后２４小时胸液量减少２９．２％（Ｐ＜０．０５），氨甲苯酸组给鱼精蛋白后１０分栓溶二聚体值明显降低（Ｐ＜０．０５），胸液量减少３２．８％（Ｐ＜０．０５）。结论：抑肽酶在ＣＰＢ初期。? Objective:To observe the changes of plasma D-dimer concentration and efficacy of antifibrinolytic agents in patients undergoing cardiopulmonary bypass(CPB) Methods:Thirty patients were divided into three groups:Group A,11 Patients received 2×106kIU aprotinin in pump prime;group B,8 patients received 250 mg paminomethyl benzoic acid(PAMBA) before,during and after CPB,respectively;group C,11 controlsDdimer were determined after the induction of anaesthesia,10 minutes after heparinization,at the 5,30 minutes and the end of CPB,10 minutes after injection of protamine and at the end of operation,respectively Results:As compared with the control group,there were slightly decrease in Ddimer(p<005) during CPB and significant decrease in chest tube drainage (p<005) at the first 24hour after operation in the aprotinin group;a significant decrease in Ddimer (p<005) after injection of protamine and 32.8% reduction in 24hour postoperative drainage in the PAMBA group Conclusion:Our results indicate that both aprotinin and PAMBA posseses antifibrinolytic effect on patients undergoing CPBThe former acts mainly at the early time of CPB,while the latter at both periCPB and postCPB periods

关 键 词：体外循环 围手术期 栓溶二聚体 抗纤溶药 

分 类 号：R654.1[医药卫生—外科学]