抑肽酶在体外循环冠脉搭桥术中的应用

背景：抑肽酶能减少体外循环心脏直视手术后引起的出血，但对初次冠脉搭桥手术的患者能否应用还存在争议。目的：研究抑肽酶对初次冠脉搭桥患者术后的止血作用及围手术期心梗发生率的影响。方法：从１９９８年８月至１９９９年５月共行体外循环冠脉搭桥术４２例，分为两组，患者的年龄，性别组成，体重、心功能，肾功能，血红蛋白、血球压积、平均搭桥数、平均主动脉阻断时间和平均体外循环时间无显著差别。比较两组的术后２４ｈ总引

Aprotinin Therapy in Primary Coronary Bypass Surgery

Backround: Aprotinin can reduce the post operative blood loss and trans fusion. Its hemostasis effect and safety for primary coronary bypass surgery are uncertain. Objective: To study the hemostasis effect and perioperative MI rate in primary CABG patients. Methods: From August 1998 to May 1999, fourly two patients who underwent CABG were divided into two groups: control group (N = 20) without Aprotinin and Aprotinin group (N = 22) with high dose of Aprotinin. The chest drainage, trans fusion volume, and the rates of graft oclussion, peroperative MI and mortality were reviewed. Results: The chest drainage and blood trans fusion were signifcantly higher in control group than in Aprotinin group (P <0. 01 ). There were no differences of postoperative average counts of Hb, Hot and Cr between two groups. Platelet count was higher in aprotinin group than in control group postoperatively (P < 0. 05). The rates of perioperative MI and operative mortality had no difference between two groups. Conclusions: Aprotinin can significantly reduce chest drainage and trans fusion without increasing the risk of MI and motality. It can be safely and effectively used in primary CABG patients.