【摘要】：目的探討氨甲環(huán)酸對(duì)老年體外循環(huán)冠狀動(dòng)脈旁路移植術(shù)患者的血液保護(hù)作用。方法采用前瞻性、隨機(jī)、雙盲實(shí)驗(yàn)法,選取該院擇期行體外循環(huán)冠狀動(dòng)脈旁路移植術(shù)的180例老年患者,分為研究組和對(duì)照組,每組90例。麻醉誘導(dǎo)后研究組患者靜脈輸注氨甲環(huán)酸,負(fù)荷劑量為10 mg/kg,之后以每小時(shí)10 mg/kg的速率輸注至手術(shù)結(jié)束;對(duì)照組患者給予等容量的生理鹽水。觀察并記錄兩組患者術(shù)后總引流量、大出血、二次開胸止血情況以及異體血使用情況、并發(fā)癥情況。結(jié)果兩組患者術(shù)后機(jī)械通氣時(shí)間、ICU停留時(shí)間、引流管使用時(shí)間、術(shù)后住院時(shí)間之間差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。研究組患者術(shù)后總引流量、術(shù)后大出血率、二次開胸止血率均明顯低于對(duì)照組(P0.05);輸入的異體血紅細(xì)胞、血小板、冰凍血漿量和使用率均明顯少于對(duì)照組(P0.05)。兩組患者圍術(shù)期并發(fā)癥發(fā)生率之間差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論氨甲環(huán)酸對(duì)老年體外循環(huán)冠狀動(dòng)脈旁路移植術(shù)患者具有明顯的血液保護(hù)作用,可有效少術(shù)后出血和異體輸血。
[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.
【作者單位】： 南京醫(yī)科大學(xué)附屬南京醫(yī)院重癥醫(yī)學(xué)科;南京市第一醫(yī)院;
【基金】：江蘇省自然科學(xué)基金面上項(xiàng)目(No.BK20141464)
【分類號(hào)】：R654.2

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