心内直视术中鱼精蛋白毒性反应的临床研究  

A clinical study of adverse reaction to protamine in open heart operation

作　　者：方强[1] 石应康[1] 万亚红[1] 武忠[1] 

机构地区：[1]华西医科大学附属第一医院心胸外科,成都610040

出　　处：《中华胸心血管外科杂志》2002年第2期93-95,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的　回顾性分析心内直视术中鱼精蛋白毒性反应发生情况 ,以总结临床特点 ,找出防治对策。方法　近两年连续 110 5例心内直视手术中 ,发生鱼精蛋白毒性反应 5 3例 ,将其分为有反应与无反应组、轻度与中重反应组 ,并比较其临床特点。结果　鱼精蛋白毒性反应发生率为 4 8%。有反应与无反应组、轻度与中重度反应组临床一般情况无明显差别。仅中重度反应组的主动脉阻断时间与鱼精蛋白毒性反应持续时间明显较轻度反应组长 (P <0 0 5 )。中重度反应组死亡率达 5 0 %。结论　心内直视术中鱼精蛋白毒性反应发生率高 ,应引起临床上足够的重视 ;鱼精蛋白毒性反应的发生难以预测 ,中重度反应死亡率高 ,预后差 ;鱼精蛋白用量应适度 。Objective: The clinical data of adverse reaction after protamine administration in open heart operation are analyzed. The clinical characteristics and treatments are summarized. Methods: The clinical data of adverse reaction after protamine were retrospectively analyzed in 1105 patients who underwent open heart operation under cardiopulmonary bypass. The clinical characteristics were compared between groups. Results: Fifty three patients (4 8%) had mild to moderate severe reactions to protamine. The crossclamp time and adverse reaction lasting time were significantly longer in moderate severe reaction group than that in mild reaction group (P<0 05). The mortality rate was 50% in the moderate severe reaction group. Conclusion: (1) The adverse reaction to protamine should be noticed because of its high incidence. (2) The reactions can not be predicted, and the prognosis is poor in moderate severe reactions. (3) Proper protamine dose, early recognizing of the clinical characteristics and immediate re bypass are important in management of the adverse reactions.

关 键 词：心内直视术 鱼精蛋白 毒性反应 临床研究 循环衰竭 

分 类 号：R654.2[医药卫生—外科学] R973[医药卫生—临床医学]