抑肽酶对肝移植患者血流动力学的保护作用

目的通过观察抑肽酶对接受原位肝移植的终末期肝病患者术中连续心排量(CCO)、体循环阻力(SVR)、肺循环阻(PVR)等参数的影响,探讨抑肽酶在肝移植手术中的血流动力学保护作用。方法64例接受同种异体肝移植的终末期肝病患者,随机分为两组:抑肽酶组(A组n=32)和对照组(C组n=32)。分别记录无肝前期、无肝期、新肝期和手术结束时(再灌注后2h)的MABP、CCO、SVR、PVR、MPAP、CVP等血流动力学参数,及两组患者术中血液制品和血管活性药物的使用情况,观察抑肽酶对血流动力学的影响。结果①抑肽酶组术中血液制品和血管活性药物的使用量明显少于对照组;②抑肽酶能明显减轻术中MABP、CCO、SVR、PVR、MPAP、CVP等血流动力学参数的波动范围,从而维持血流动力学的相对稳定。结论肝移植患者术中预防性使用抑肽酶可以减少术中失血量,降低血液制品的使用量,减少血管活性药物的使用次数,更有利于维持血流动力学的稳定性。

Protective effect of aprotinin for the hemodynamics in the patients with orthotopic liver transplantation(OLT)

Objective To investigate the effects of aprotinin on haemodynamic parameters and explore its possible protective effect on orthotopic liver transplantation(OLT).Methods In the 64 patients,32 were treated with aprotinin randomly and the others were selected as control group.Hemodynamics parameters including MABP,CCO,SVR,PVR,MPAP and CVP were recorded before anhepatic phase,at anhepatic phase,after grafting and 2 hours after reperfusion,respectively.Blood products and vasoactive medicine were observed.Results In the patients receiving aprotinin,vasopressor needs were reduced and a relative haemodynamic stability was established.Conclusions Aprotinin can reduce intraoperative blood loss and the use of vasoactive medicine,which may play a important role in keeping haemodynamic stability.