摘要
目的 选择房缺、室缺修补术患者与心脏瓣膜置换术患者 ,应用小剂量抑肽酶 ,观察其减少术后失血量的效果并加以比较 ,探讨抑肽酶的作用机制。方法 40例房缺、室缺修补术患者分为对照组 (A1n =2 0 ) ,小剂量抑肽酶组 (A2 n =2 0 ) ,38例瓣膜置换术患者分为对照组 (B1n =2 0 ) ,小剂量抑肽酶组 (B2 n =18) ,于麻醉后 (T1)、转机后 10min(T2 )、鱼精蛋白拮抗后 10min(T3 )、体外循环后 2h(T4 )各时间上测定FDP(纤维蛋白降解产物 )、Fib(纤维蛋白 )、ACT(全血激活凝固时间 )、血小板计数。结果 FDP、Fib在T2 、T3 、T4 时A2 明显优于A1(P <0 0 1) ,在T2 时B2 与B1比较有显著性差异 (P <0 0 5 ) ,2 4h渗血量B2 明显多于A2 (P <0 0 1)。结论 小剂量抑肽酶在减少术后渗血量方面用于房缺、室缺修补术效果好 ,而瓣膜置换术患者效果欠佳 ,应加大剂量。
Objective: To compare the effects of low dose aprotinin on different diseases during cardiopulmonary bypass. Methods: Forty patients of ASD and VSD undergone cardiopulmonary bypass (CPB) were divided into the two groups (n=20): control(A 1), low dose aprotinin (A 1). Thirty eight patients of cardial valve replacement were divided into the two groups (n=19): control (B 1), low does aprotinin (B 1). Plasma levels of FDP(Fibrinogen and fibrin degradation products), Fib(fibrin), Act(Activated clotting time), platelet counts (PLC) were measured at the following times: before CPB(T 1), 10 min after CPB(T 2), 10 min after protamine from CPB(T 3), 2 h after weaning from CPB(T 4). Results: The values of DP and Fib in A 1 group were higher than those in A 2 group in levels at T 2 ,T 3,T 4. The values in B 1 group were higher than those in B 2 in levels at T 2. ACT in A 2.B 2 group were longer than A 1. B 1 at T 2. PLC in all the groups were low at T 2. Conclusions: Low dose aprotinin is more effective to reduce the postoperative blood loss in ASD and VSD patients than those in cardial valve replacements
出处
《泰山医学院学报》
CAS
2000年第4期308-310,共3页
Journal of Taishan Medical College
