氨甲环酸在开胸手术中的应用

被引：5

作者：

胡弋

葛衡江

闫红

机构：

[1] 第三军医大学大坪医院野战外科研究所

来源：

四川医学 | 2006年 / 02期

关键词：

氨甲环酸; 开胸手术; 凝血; 纤溶;

D O I：

10.16252/j.cnki.issn1004-0501-2006.02.031

中图分类号：

R655 [胸部外科学];

学科分类号：

1002 ; 100210 ;

摘要：

目的评价氨甲环酸在开胸手术中的止血作用和对开胸手术围术期凝血纤溶功能的影响。方法选择因罹患肺或食管肿瘤的开胸手术患者40例,随机分为两组:氨甲环酸组(A组,n=20)在麻醉诱导后切皮前静脉滴注10mg/kg氨甲环酸,术中持续泵注1mg.kg-1.h-1至术毕;对照组(B组,n=20)持续泵注生理盐水。分别于术前,术中3h,术后第1天和第3天抽取中心静脉血检测血栓弹力图(TEG),凝血常规,包括凝血酶原时间(PT),部分活化凝血酶时间(APTT)和纤维蛋白原(Fib)含量,及血浆D-二聚体含量,并记录术中出血量和术后24h胸腔引流量。结果T组术中、术后CI均明显高于对照组,术后LY30显著低于对照组(P<0.05);T组术中和术后D-二聚体含量均明显低于C组(P<0.01);T组术中出血量和术后24h胸腔引流量明显少于C组(P<0.01)。结论氨甲环酸抑制了纤溶活性的增强,改善了开胸手术后早期的低凝状态,显著减少了开胸手术围术期的血液丢失。

引用

页码：162 / 164

页数：3

共 9 条

[1]

Does prophylactic tranexamic acid s-afely reduce bleeding without increasing thrombotic complications in pa-tients undergoing cardiac surgery. Sundaramoorthi T,Adrian L,Joel D. Interactive Cardiovascular and Tho-racic Surgery . 2004

[2]

Towards evidence based m-edicine in cardiothoracic surgery:best BETS. Dunning J,Prendergast B,Mackway Jones K. Interact Cardiovasc Tho-rac Surg . 2003

[3]

The dose-response relation-ship of tranexamic acid. Horrow JC,Van Riper DF,Strong MD,et al. Anesthesiology . 1995

[4]

Tranexamic acid reduces blood loss in totalhip replacement surgery. Ekback G,Axelsson K,et al. Anesthesia and Analgesia . 2000

[5]

The efficacy of tranexamic acid versus place-bo in decreasing blood loss in pediatric patients undergoing repeat cardiacsurgery. Reid R,Zimmerman A,et al. Anesthesia and Analgesia . 1997

[6]

Tranexamic acid(Cyklok-apron)is not necessary to reduce blood loss after coronary artery bypassoperations[see comment]. Ovrum E,Am Holen HE,Abdelnoor M,et al. Journal of Thoracic and Cardiovascular Surgery . 1993

[7]

Tranexamic acid reduces bleed-ing and the need for blood transfusion in primary myocardial revasculariza-tion. Zabeeda D,Medalion B,Sverdlov M,et al. The Annals of Thoracic Surgery . 2002

[8]

Prophylactic tranexamic acid in elective,primary coro-nary artery bypass surgery using cardiopulmonary bypass. Jan JA,Conny N. EuropeanJournal of Cardio Thoracic Surgery . 2004

[9]

The effectiveness of low dosetranexamic acid in primary cardiac surgery. Lambert W,Brisebois FJ,Wharton TJ,et al. Canadian Journal of Anaesthesia . 1998

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