不同剂量血凝酶在先天性心脏病手术中的临床效果观察

目的:观察不同剂量血凝酶在先天性心脏病手术中的临床效果。方法:筛选先天性心脏病手术患者84例,随机分为常规血凝酶组(n=28)、加倍血凝酶组(n=28)和对照组(n=28),常规血凝酶组和加倍血凝酶组在撤离体外循环、开始缝心包时经中心静脉分别给予常规剂量血凝酶、加倍剂量血凝酶静脉推注,对照组不用止血药。观察用药24h内胸腔引流量、输血量、输血浆量及血压、心率、呼吸及全身情况。结果:加倍血凝酶组术后24h内胸腔引流量、输血量及输血浆量少于常规血凝酶组(P<0·05),显著少于对照组(P<0·05),且不增加不良反应及并发症。结论:在先天性心脏病手术中应用加倍剂量血凝酶,临床效果良好且安全。

Clinical Application of Hemocoagulase in Congenital Heart Disease Surgery

OBJECTIVE： To review our experience of using hemocoagulase for congenital heart disease.METHODS： 84 patients with congenital heart disease scheduled for elective open - heart surgery were randomly divided into three groups： usual - hemocoagulase group（ n = 28）, double - hemocoagulase group（ n = 28） and control group（ n = 28） .Usual - hemocoagulase group received usual dose of hemocoagulase and double - hemocoagulase group received double dose of hemocoagulase via central veins after termination of extracorporeal circulation when pericardium suturing surgery has just begun.Control group were treated without anthemorrhagic drug.The volume of postoperative thoracic drainage, blood transfusion volume, plasma transfusion volume, blood pressure, heart rate, respiration and general state in these groups were measured at 24 h after operation. RESULTS：The thoracic drainage volume, blood transfusion volume and plasma transfusion volume in double- hemocoagulase group at 24 h after operation were all lower than in usual - hemocoagulase group（P〈 0.05） and significantly lower than in control group（P〈0.05）, yet without increase of adverse drug reactions and complications.CONCLUSION： Large dose of hemocoagulase applied in patients undergoing surgery of congenital heart disease has been proved to he of good, safe and reliable hemostasis.