抑肽酶联合控制性降压在脊柱手术中的应用

目的 探讨抑肽酶联合控制性降压在脊柱手术中应用的血液保护效应.方法 45例择期行脊柱手术患者,随机均分为抑肽酶联合控制性降压组(联合组)、单纯控制性降压组(降压组)和对照组.分别在术前、术毕、术后24 h抽血检测血常规和凝血功能.比较三组患者手术失血量、输血量和凝血功能变化.结果 联合组与降压组手术失血量、输血量、术后24 h切口引流量均较对照组明显下降(P<0.01),联合组上述指标低于降压组(P<0.05).与对照组和降压组比较,联合组术后部分凝血活酶时间(APTT)延长(P<0.01),纤维蛋白原(Fib)值偏高(P<0.05).结论 抑肽酶联合控制性降压可明显减少脊柱手术的失血量和异体血的输入量.

Application of aprotinin combined with deliberate hypotension in spinal surgery

Objective To investigate the blood conservation outcome of aprotinin combined with deliberate hypotension in spinal surgery.Methods Forty-five patients undergoing spinal surgery were randomly allocated into three groups with 15 cases each: Aprotinin combined with deliberate hypotention was used in group A,the deliberate hypotention only in group B,and no aprotinin or deliberate hypotension in group C.Venous blood was drawn for detecting the coagulation parameters before operation,at the end of operation,24h after operation.The volume of hemorrhage and transfusion was recorded.Results Compared with group C,blood loss during operation and 24 h after the operation was significantly less in group A than that in group B and C(P<0.01).So did the volume of transfusion(P<0.01).The coagulation parameters were reduced more significantly in group A than those in group B(P<0.05).Compared with group C and B,the values of APTT and Fib were significantly increased in group A(P<0.05 or P<0.01).Conclusion Application of aprotinin combined with deliberate hypotension is effective in reducing blood loss and transfusion in patients undergoing spinal surgery.