氨甲环酸对老年体外循环冠状动脉旁路移植术患者的血液保护作用

发布时间：2018-09-09 15:57

【摘要】：目的探讨氨甲环酸对老年体外循环冠状动脉旁路移植术患者的血液保护作用。方法采用前瞻性、随机、双盲实验法,选取该院择期行体外循环冠状动脉旁路移植术的180例老年患者,分为研究组和对照组,每组90例。麻醉诱导后研究组患者静脉输注氨甲环酸,负荷剂量为10 mg/kg,之后以每小时10 mg/kg的速率输注至手术结束;对照组患者给予等容量的生理盐水。观察并记录两组患者术后总引流量、大出血、二次开胸止血情况以及异体血使用情况、并发症情况。结果两组患者术后机械通气时间、ICU停留时间、引流管使用时间、术后住院时间之间差异均无统计学意义(P0.05)。研究组患者术后总引流量、术后大出血率、二次开胸止血率均明显低于对照组(P0.05);输入的异体血红细胞、血小板、冰冻血浆量和使用率均明显少于对照组(P0.05)。两组患者围术期并发症发生率之间差异无统计学意义(P0.05)。结论氨甲环酸对老年体外循环冠状动脉旁路移植术患者具有明显的血液保护作用,可有效少术后出血和异体输血。
[Abstract]:Objective to investigate the blood protective effect of carbamate on coronary artery bypass grafting (CABG) in elderly patients with cardiopulmonary bypass (CPB). Methods A prospective, randomized, double-blind trial was carried out. 180 elderly patients undergoing coronary artery bypass grafting under cardiopulmonary bypass (CPB) were divided into study group and control group with 90 cases in each group. After anesthesia induction, the patients in the study group were given intravenously methoxylic acid at a loading dose of 10 mg/kg, at the rate of 10 mg/kg per hour to the end of the operation, while the patients in the control group were given the same volume of normal saline. The total drainage, bleeding, hemostasis, allogeneic blood use and complications were observed and recorded in the two groups. Results there was no significant difference in postoperative mechanical ventilation time, ICU residence time, drainage tube usage time and postoperative hospitalization time between the two groups (P0.05). In the study group, the total drainage volume, postoperative bleeding rate, secondary thoracotomy hemostasis rate were significantly lower than those in the control group (P0.05); the amount of imported allogeneic red blood cells, platelets, frozen plasma and the utilization rate were significantly lower than those in the control group (P0.05). There was no significant difference in the incidence of perioperative complications between the two groups (P0.05). Conclusion MCA has a significant blood protective effect on the elderly patients with coronary artery bypass grafting under cardiopulmonary bypass, and can effectively reduce postoperative bleeding and allogeneic blood transfusion.
【作者单位】：南京医科大学附属南京医院重症医学科;南京市第一医院;
【基金】：江苏省自然科学基金面上项目(No.BK20141464)
【分类号】：R654.2

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