氨甲环酸对冠状动脉旁路移植术后出血疗效观察(1)
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2010年7月5日
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[摘要] 目的:观察冠状动脉旁路移植术(coronary artery bypass graft,CABG)后应用氨甲环酸(tranexamic acid, TA)对术后出血的治疗效果。方法:选择2006年6月～2009年10月在本院接受CABG的60例患者,将其随机分为氨甲环酸组(31例)和对照组(29例),在CABG术前和术中分别静脉注射氨甲环酸和等量的0.9%氯化钠溶液,观察TA在CABG后24 h对总失血量和输血量的影响及术前和术后3 h D-dimer水平的变化。结果:CABG术后24 h氨甲环酸组的总失血量(450±205) ml显著少于对照组(863±343) ml,且术中输血量TA组显著少于对照组。术后对照组的血浆D-dimer水平显著增加,而TA组的D-dimer水平无显著变化。结论:与对照组相比,氨甲环酸可以发挥抗纤溶作用,并能够有效地降低CABG术后出血。
[关键词] 冠状动脉旁路移植术;氨甲环酸;术后出血
[中图分类号] R973 [文献标识码]B [文章编号]1674-4721(2010)07(a)-061-02
Tranexamic acid reduces postoperative bleeding in coronary artery bypass graft
REN Mingming,HAN Zhen,LI Jinglai,CHENG Ying,WU Yongqian
(Department of Cardiovascular Surgery of Peking University Shenzhen Hospital,Guangdong Province,Shenzhen 518036,China)
[Abstract] Objective:To evaluate the treatment effect of tranexamic acid reduces postoperative blood loss in coronary artery bypass surgery. Methods: 60 patients undergoing coronary artery bypass graft (CABG) from June 2006 to October 2009 in department of cardiac surgical were randomly selected and enrolled into the study, and divided into tranexamic acid (TA) group(31 patients) and placebo group(29 patients), the TA group received an intravenous TA before the skin incision and followed by a continuous infusion, the placebo group received an identical syringe of normal saline solution. The effect of TA reduced total blood loss in 24 h and the blood transfusion were observed. Also observed the change of D-dimer level. Results: 24 hours postoperative blood loss was significantly less in the tranexamic acid group(450±205) ml than that of the placebo group(863±343) ml, and the intraoperative blood transfusion in TA group was significantly less than that of placebo group. There was significant increase in plasma D-dimer levels after CABG only in patients of the placebo group, whereas no significant changes were observed in the group treated with tranexamic acid. Conclusion: Compare to the placebo group, trannexamic acid may play a role in anti-fibrinolytic and appears to be effective in reducing the postoperative blood loss ......
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