Ait Houssa M, Boulahya A, Wahid F A, Elbekkali Y, Amahzoune B, Selkane C, Elkirat A, Jabrani K, Ibbat D, Azendour H, Mamoun F, Arji M
Service de chirurgie cardiovasculaire, hôpital militaire d'instruction Mohammad V, BP 10100, Hay Riad Rabat, Maroc.
Ann Cardiol Angeiol (Paris). 2003 Apr;52(2):125-8. doi: 10.1016/s0003-3928(02)00193-2.
This retrospective stady has for objective to compare the effect of Tranexamic Acid (TA) to the low dose of aprotinin (AP) in primary mitral valve surgery in terms of blood loss and transfusion requirements.
Are included in the study operated patients of a valvulopathy mitral isolated. Two groups of 50 patients are collected. The tranexamic acid group has received 30 mg kg-1 the acid tranexamic and the aprotinin group has received a low regimen as 500,000 UIK of aprotinin. Blood loss by the chest drains are assessed to different times during first 24 hours post cardiopulmonary bypass. In the same way, we have measured the platelet and fibrinogen count. Blood products were administered according to a classic protocol.
The two groups are comparable clinic and echocardiographic parameters what authorizes us an appariement acceptable. Various cardiopulmonary bypass times are almost similar. We noticed a tendency to excessive blood loss processed by low regimen aprotinin and a significant rate difference of platelet and the fibrinogen level. But no complication has been recorded in the two groups.
This study demonstrates relatively different effect of the two fibrinolytics inhibitors in primary mitral valve surgery. As for the superiority of one of the two produces, it needs a confirmation by a randomised and controlled clinical trial.
本回顾性研究旨在比较氨甲环酸（TA）与低剂量抑肽酶（AP）在原发性二尖瓣手术中对失血和输血需求的影响。
纳入孤立性二尖瓣病变的手术患者进行研究。收集两组各50例患者。氨甲环酸组接受30mg/kg的氨甲环酸，抑肽酶组接受500,000国际单位的低剂量抑肽酶。在体外循环后的头24小时内的不同时间评估胸腔引流管的失血量。同样，我们测量了血小板和纤维蛋白原计数。根据经典方案给予血液制品。
两组在临床和超声心动图参数方面具有可比性，这使我们能够进行可接受的比较。各种体外循环时间几乎相似。我们注意到低剂量抑肽酶处理的失血有增加趋势，且血小板和纤维蛋白原水平存在显著差异。但两组均未记录到并发症。
本研究表明两种纤溶抑制剂在原发性二尖瓣手术中的作用相对不同。至于两种药物中哪种更具优势，需要通过随机对照临床试验来证实。
