【摘要】 目的　观察 6-氨基己酸 (EACA)对儿童体外循环 (CPB)时纤溶系统有关变量及术后出血的影响 ,探讨其作用机制。方法　 3 0例先心病患儿随机均分为用药组 (EACA组 )和对照组 (C组 )。CPB前、CPB 15min、CPB 3 0min、术后 2h、术后 2 4h分别测定t-PA和PAI活性、D -D含量、HCT ,记录术后 2 4h心包纵隔引流量。结果　用药组与对照组相比 :术中及术后t PA活性明显减低 ,t-PA/PAI比值较稳定 ,术后 2hPAI水平明显升高 ;D -D含量在各时点均减少 ;术后 2 4h失血量减少4 3 8%。结论　EACA可有效地抑制儿童CPB期间纤溶系统的激活 ,明显减少术后失血量。更多还原

【Abstract】 Objective To investigate the protective effect of epsilon aminocaproic acid(EACA)on the fibrinolytic system and postoperative bleeding in children undergoing cardiopulmonary bypass. Methods Thirty children with congenital heart disease were randomly divided equally into 2 groups: group EACA and group C(control). Blood samples were taken from patients in the study groups at the following time points:before the onset of CPB, at min 15 and 30 after CPB onset and at h 2 and 4 after operation.Measured parameters included tissue type plasminogen activator(t-PA), plasminogen activator inhibitor(PAI), D-dimer(D-D),hematocrit, blood gas and activated clotting time(ACT). Postoperative 24 h bleeding amount was recorded. Results The t-PA activity in group C were elevated significantly during operation and at h 2 after operation ( P <0 05),but elevated significantly at 24 h after operation compared with preoperative value( P <0 05). The ratios of t-PA/PAI increased significantly during operation and at h 2 after operation ( P <0 01),and returned to normal levels 24 hours later. The content of D-D increased significantly during and after operation( P <0 01).The t-PA activity was significantly lower in group EACA than in group C during operation and at h 2 after operation( P <0 05). The PAI activity in group EACA was significantly higher than in group C( P< 0 05). The 24 h amount of bleeding in group EACA reduced 43 8% compared with that in group C (P<0 05).Conclusion EACA can inhibit the activation of the fibrinolytic system during CPB in children patients, and reduce the postoperative bleeding remarkably.更多还原