【摘要】 目的:评估氨甲环酸和半量抑肽酶在非体外循环冠状动脉搭桥术(OPCAB)的止血作用。方法:112例 OPCAB 患者随机分为3组,分别接受半量抑肽酶(抑肽酶组,n=36)、氨甲环酸(氨甲环酸组,n=36)或等量生理盐水(对照组,n=40)。记录术后出血量、输血情况以及其他相关临床指标。结果:抑肽酶组及氨甲环酸组术后出血量较对照组明显减少(P<0.05)。抑肽酶组和氨甲环酸组术后 D-二聚体水平的升高受到明显抑制(P<0.05)。各组围术期血小板计数和黏附率未见显著变化。结论:在 OPCAB 中应用半量抑肽酶和氨甲环酸是安全的,二者有相近的抗纤溶作用,均能明显减少术后出血、抑制纤溶亢进,但不影响术后血小板功能。更多还原

【Abstract】 Objectives:To evaluate the hemostatic effects of tranexamic acid and half dose aprotinin in patients undergoing off-pump cor- onary artery bypass(OPCAB). Methods:One hundred and twelve patients were randomized into three groups;half dose aprotinin,tranexamic acid or saline solution.Perioperative hematochemical parameters including platelet adhesion rate,D-dimer,were observed.Postoperative blood loss,blood transfusion and other clinical data were recorded. Results:Cumulative blood loss during at 6 h and 24 h was significantly reduced in patients treated with aprotinin or tranex- amie acid(P<0.05).Levels of D-dimer were raised after surgery,but significantly lower in aprotinin and tranexamie acid groups as compared to the controls(P<0.05).Platelet adhesion rate in all groups had no significant changes at perioperation (P>0.05). Conclusion:The present results show that half-dose aprotinin and tranexamic acid have similar hemostatic effect in patients undergoing OPCAB.更多还原