【摘要】 目的探讨心脏恶病质瓣膜替换术时联合应用抑肽酶和凝血酶原复合物对术后凝血机制恢复的影响。方法40例适合心脏恶病质瓣膜替换术的患者,按体外循环时间长短,平均进入实验组(20例)和对照组(20例)。对照组在麻醉后转机前静脉滴注抑肽酶100～150万kIU,预充液中加150～200万kIU。实验组在此基础上加用凝血酶原复合物10～20 PE/kg。结果术后实验组凝血酶原时间(PT)较对照组更接近正常(P<0.01)。术后18 h出血量实验组较对照组减少45.59%,输血量减少46%(P<0.01)。结论心脏恶病质瓣膜替换术联合应用抑肽酶和凝血酶原复合物能更有效地恢复术后凝血机制,从而进一步减少术后出血。更多还原

【Abstract】 Objective To study the effect of aprotinine combined with human lyophilized prothrom- bin complex on postoperative bleeding after the prosthetic valve replacement operation with cardiac cachexia. Methods 40 patients underwent valve replacement with cardiac cachexia were divided into the study group (n=20)and the control group(n=20)according to the time of extracorporeal circulation.Aprotinine was administered 1000 000～2500 000 kIU intravenously and 1500 000～2 000 000 kIU was added in priming fluid of cardiopulmonary bypass machine in the control group.The study group was treated as the coutrol group,except for plusing human lyophilized prothrombin complex 10～20 PE/kg.Results Compared with the control group,the postoperative prothrombin time of the study group was nearer to normal(P<0.01). Mean blood loss after eighteen hours and the total blood use decreased significantly from 908 and 630 in con- trol to 494 and 340 in study(P<0.01).Conclusion Aprotinine combined with human lyophilized pro- thrombin complex after the prosthetic valve replacement operation with cardiac cachexia may have a great effect on restoring coagulative system and result in the reduction of post operative blood loss.更多还原