体外循环期间抑肽酶不同给药方式对血小板保护的临床研究  

Different ways of delivery of aprotinin on the protection of platelet

作　　者：刘建[1] 陈锁成[1] 董长青[1] 任正兵[1] 宗白鹭[1] 邵东华[1] 尹宁[1] 王康荣[1] 

机构地区：[1]镇江市第一人民医院心胸外科,江苏镇江212001

出　　处：《医学研究生学报》2002年第5期411-413,共3页Journal of Medical Postgraduates

基　　金：江苏省科委立项; 镇江市科委资助项目 (批准号 :SG980 61)

摘　　要：目的 :探讨抑肽酶不同给药方式对体外循环 (CPB)期间血小板功能的保护效果。　方法 :选择心脏瓣膜置换术患者 2 0例 ,在CPB围手术期给予抑肽酶 5～ 8万U/kg ,按给药方式不同随机分为 2组 ,对照组在预充液中一次性给药 ,试验组于麻醉诱导后、机器预充液中、停机后分别给药 1/ 3量。分别于肝素化后 10min、CPB 30min、主动脉开放时、CPB结束时、CPB结束后 2h几个时点 ,定量检测α 颗粒蛋白 (GMP 14 0 )、血栓烷B2 (TXB2 )、11 去氢 血栓烷B2 (DH TXB2 )、血小板计数及术后第一天的胸腔积液量、手术过程的输血量等指标 ,运用SPSS软件包进行统计学分析。　结果 :肝素化后 10min、CPB结束时、CPB结束后 2h ,对照组血小板计数较试验组明显减少 ;GMP 14 0、TXB2 、DH TXB2 在主动脉开放前两组无差异 ,开放后至术后 2h对照组明显高于试验组 ,术后第一天的出血量及手术的总输血量也明显少于对照组。　结论Objectives:To investigate the effect of repeated delivery and single delivery of aprotinin on platelets protection. Methods:In a prospective trial, 20 patients with rheumatic valvular diseases were randomly divided into 2 groups: Control group(A):Aprotinin was used only once during CPB. Test group(B): the same dosage of aprotinin was divided into 3 parts and was delivered before anesthesia, at cardiopulmonary bypass(CPB),and after CPB respectively. Blood samples were collected at 10 minutes after heparinization,30 minutes after CPB, reopening of aorta, during CPB and 2 hours after CPB to measure GMP 140, TXB 2 and DH TXB 2. Platelet counts, the volume of mediastinal drainage, and the mount of blood transfusion during operation were recorded. Results:In group B, blood platelets count were reduced significantly than group A. GMP 140,TXB 2 and DH TXB 2 were the same in group A and group B before reopening of aorta, but they were increased after reopening of aorta in group B. The volume of mediastinal drainage and blood transfusion during operation was much less in group B. Conclusions:Repeated delivery of aprotinin was protective to platelet.

关 键 词：体外循环 抑肽酶 给药方式 血小板保护 临床研究 

分 类 号：R654.1[医药卫生—外科学]