体外循环中应用鱼精蛋白的不良反应及其预防  

Adverse reaction and its prevention of the use of protamine in extracorporeal circulation

作　　者：王福昌[1] 韩忠[1] 

机构地区：[1]济南铁路中心医院心胸外科,山东济南250001

出　　处：《铁道医学》2001年第4期278-279,共2页Railway Medical Journal

摘　　要：鱼精蛋白是目前实施体外循环手术中中和肝素最常用的药物。体外循环中鱼精蛋白的不良反应可分为三种类型 :快速给药型、过敏反应型、严重肺血管收缩型。主要预防措施为 :(1)对可疑的鱼精蛋白过敏者做好预防及抗过敏的准备。 (2 )经左心缓慢给药。 (3 )可同时给予钙剂或H1、H2 受体阻滞剂。 (4)鱼精蛋白倾向于小剂量 ,防止过量。 (5 )体外循环手术中应用鱼精蛋白替代物。Protamine can be used to neutralize heparin in extracorporeal blood circulation(ECBC).It can cause many adverse reactions,which were classified as fast administration reaction type,anaphylactic reaction type and catastrophic pulmonary vasoconstriction type.The main preventive methods include paying attention to the history of anaphylactoid,pretreatment with calcium or H 1,H 2 receptor blocking agent,slow administration of protamine through left heart.Recombinant platelet factor 4 can be used to substitute for protamine in patients during ECBC.The use of a heparin removal device is also as efficient as systemic administration of protamine to reverse the effects of heparinization.

关 键 词：体外循环 鱼精蛋白 不良反应 预防 

分 类 号：R654.1[医药卫生—外科学]