Haddad R, Kesrouani C, Nasr W
Department of Surgery, American University of Beirut-Medical Center, Beirut, Lebanon.
J Med Liban. 2000 May-Jun;48(3):157-60.
Patients with heart disease are frequently maintained on a regimen of aspirin. During cardiac surgery aspirin-induced platelet dysfunction increases the risk of bleeding.
The files of 82 patients who had undergone open-heart surgery were selected to study the efficacy of the low-dose (2 million KIU) aprotinin regimen in decreasing blood loss and transfusion requirements for patients receiving aspirin. Patients were divided into three groups: Group 1, includes those who received neither aspirin nor aprotinin (n = 41), Group 2, received both aspirin and aprotinin (n = 27) and Group 3, did not receive aprotinin despite aspirin intake (n = 14). Primary outcome measures in this study were total volume of blood loss (postoperative chest tube drainage) and volume of transfusions during hospitalization.
Patients treated with aprotinin (Group 2) had significantly lower total blood loss (359 ml versus 527 ml and 628 ml in Group 1 and Group 3, p < 0.05), rates of bleeding (17.2 ml/hr versus 25.7 and 30.4 ml/hr in groups 1 and 3 respectively). A significant difference was also found when comparing the volume of blood transfusions (224.4 ml versus 262.4 and 537.5 ml) and prevalence of transfusion (33.3% versus 36.6% and 64.3%).
Low-dose aprotinin significantly reduces blood loss and blood transfusions in patients receiving aspirin who undergo cardiac operations.
心脏病患者常采用阿司匹林治疗方案。心脏手术期间，阿司匹林诱导的血小板功能障碍会增加出血风险。
选取82例接受心脏直视手术的患者资料，研究低剂量（200万KIU）抑肽酶方案对接受阿司匹林治疗患者减少失血量和输血需求的疗效。患者分为三组：第1组，包括未接受阿司匹林和抑肽酶治疗的患者（n = 41）；第2组，接受阿司匹林和抑肽酶治疗的患者（n = 27）；第3组，尽管服用阿司匹林但未接受抑肽酶治疗的患者（n = 14）。本研究的主要观察指标为失血量总量（术后胸腔引流管引流量）和住院期间输血量。
接受抑肽酶治疗的患者（第2组）总失血量显著较低（分别为359 ml，第1组和第3组为527 ml和628 ml，p < 0.05），出血率（分别为17.2 ml/hr，第1组和第3组为25.7 ml/hr和30.4 ml/hr）。在比较输血量（分别为224.4 ml，第1组和第3组为262.4 ml和537.5 ml）和输血发生率（分别为33.3%，第1组和第3组为36.6%和64.3%）时也发现了显著差异。
低剂量抑肽酶可显著减少接受阿司匹林治疗并进行心脏手术患者的失血量和输血量。
