摘要
目的 观察乌司他丁、氨甲环酸两种药物作用下 ,心内直视手术患者体外循环 (CPB)中血浆D 二聚体 (D D)的变化 ,以了解两者在CPB中的血液保护效果。方法 在 5 3例心脏手术患者CPB中 ,随机分别加入乌司他丁、氨甲环酸以及生理盐水(对照组 ) ,在全身肝素化前、转流 15min、转流 4 5～ 6 0min、转流结束肝素被中和后 10min分别测D D的含量。结果 3组患者在同一时间测定的D D值比较 ,除了全身肝素化前各组间无显著性差异外 ,其余各时间段 ,用药组与对照组均有差异 ;两用药组数据 ,相邻组间比较没有差异。乌司他丁组与氨甲环酸组测定的D D值进行组内比较 ,相邻组内统计学上比较均没有差异 ,对照组相邻组内比较有显著差异。尽管在血液保护剂作用下 ,血浆D D的延长时间有所缩短 ,但仍与转流时间成正比。结论 D D的检测可作为CPB导致继发性纤溶程度的指标。在体外循环中乌司他丁与氨甲环酸均有一定的血液保护作用 ,保护作用两者无明显差异 ,但氨甲环酸的价格便宜 ,值得推广使用。体外循环中为了更好地血液保护 。
OBJECTIVE To study the blood conservative effects of ulinastatin and tranexamic acid during cardiopulmonary bypass.METHOD Fifty-three open heart surgery patients were divided into 3 groups randomly. Normal saline (n=15); tranexamic acid (n=20) and ulistatin (n=18).D-dimer were assessed before heparinization,15min, 45～60min after bypass and 10min after heparin neutralization.RESULTS The plasma D-dimer content were similar in all groups before heparinization, but the controls were much higher than drug-treated patients (P< 0.01). There were no difference between the drug-treated groups (P>0.05) at the same time intervals. Although ulinastation and tranexamic acid had antifibrinllytic effects, but the D-dimer content was proportional with CPB time. CONCLUSION The plasma D-dimer content was the useful index of secondary fibrinolysis during cardiopulmonary bypass. Ulinastation and tranexamic acid have some blood conservative effects.Tranexamic acid is as good as ulinastation, but is cheaper than ulinastation. However, the CPB time should be controlled as short as possible for the better blood conservation.
出处
《中国现代应用药学》
CAS
CSCD
北大核心
2004年第5期420-421,共2页
Chinese Journal of Modern Applied Pharmacy
