注射用人纤维蛋白原在心外科手术患者中临床用药分析

发布时间：2018-12-10 17:01

【摘要】：目的分析注射用人纤维蛋白原(FIG)在心外科手术患者中的临床应用情况。方法利用医院信息系统及阳光用药系统调取使用注射用FIG的全部住院患者病例,收集患者基本信息、用药情况、凝血功能检验指标、血液制品输注量,进行回顾性调查分析。结果共计调查分析300例手术患者,其中行主动脉夹层手术174例、心脏瓣膜手术79例、其他类型手术47例,术前血浆FIG低于下限者分别占22.9%、7.6%、10.6%,不同心脏手术类型患者术前血浆FIG水平比较差异无统计学意义。术后96例追加使用注射用FIG,其中主动脉夹层手术65例、心脏瓣膜手术18例、其他类型手术13例,均输注血液制品;主动脉夹层手术者术中注射用FIG用量、术后FIG追加用量、用药金额比例、促凝血药物联合用药量、血液制品输注量均高于心脏瓣膜手术及其他类型手术患者,引流管留置天数短于心脏瓣膜手术及其他类型手术患者(P均0.05)。结论心外科注射用FIG给药并非仅限于低FIG血症患者,其在围手术期使用剂量、血浆纤维蛋白原水平临界值及目标值仍不确定;注射用FIG在主动脉夹层手术患者中使用率高、用量大、联合使用注射用人凝血酶原复合物剂量大,住院期间FIG用药金额占住院总用药金额比例较高。
[Abstract]:Objective to analyze the clinical application of human fibrinogen (FIG) for injection in cardiac surgery. Methods all the inpatients with FIG for injection were collected by the hospital information system and the sunshine medication system. The basic information of the patients, the drug usage, the blood coagulation function test index and the transfusion quantity of the blood products were collected and analyzed retrospectively. Results A total of 300 patients underwent aortic dissection, 79 heart valve operations and 47 other types of surgery were investigated and analyzed. The patients whose plasma FIG was lower than the lower limit were 22. 9%, 7. 6% and 10. 6%, respectively. There was no significant difference in plasma FIG levels between patients with different types of cardiac surgery before operation. After operation, 96 cases were given additional FIG, for injection, including 65 cases of aortic dissection, 18 cases of cardiac valve surgery and 13 cases of other types of operation, all of them were infused with blood products. In patients with aortic dissection, the dosage of FIG for injection, the additional dosage of FIG after operation, the proportion of the amount of money used, the combined dosage of coagulant drugs and the volume of transfusion of blood products were all higher than those of patients undergoing cardiac valve operation and other types of operation. The days of drainage tube indwelling were shorter than that of cardiac valve operation and other types of operation (P 0.05). Conclusion the administration of FIG for cardiac surgery is not limited to hypoFIG patients. The plasma fibrinogen threshold and target value are still uncertain in the perioperative period. The usage rate of FIG for injection was high in patients with aortic dissection, and the dosage of combined use of human prothrombin complex for injection was large. The amount of FIG used in hospital was higher than that in total amount of money used in hospital.
【作者单位】：深圳市孙逸仙心血管医院;
【分类号】：R654.2

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