Szécsi J, Bátonyi E, Rédai I, Szabó Z, Herman K, Liptay P, Medgyessy I, Péterffy A
II. Sebészeti Klinika, Debreceni Orvostudományi Egyetem.
Orv Hetil. 1990 Dec 23;131(51):2809-14.
Authors have studied the effect of Gordox-therapy on haemostasis after open heart surgery in a prospective clinical trial. Thirty seven patients (pts) undergoing cardiac surgery due to their valve disease were randomly assigned either to control-group (20 pts) or to Gordox-group (17 pts). The patients in the Gordox group were given Gordox according the following scheme: 2 M IU within 20 min. after induction of anaesthesia followed by 0.5 M IU/hour infusion until the end of the operation. One M IU also was given into the oxygenator before starting the extracorporeal circulation. The postoperative chest tube drainage was less in Gordox-group (534 +/- 260 ml vs. 987 +/- 583 ml, p less than 0.005), and donor blood and fresh frozen plasma requirement was also lower in this group (534 +/- 633 ml vs. 935 +/- 718 ml p less than 0.05; 70 +/- 153 ml vs. 211 +/- 245 ml p less than 0.05, respectively). There was no significant difference between the two groups concerning the postoperative activated partial thromboplastin time, prothrombin time, thrombin time values. The authors could document significantly higher fibrinogen concentration and significantly lower fibrinolytic activity postoperatively in the Gordox-group (p less than 0.05). Gordox therapy has advantageous effect on haemostasis after open heart surgery which can be documented both by clinical and laboratory examination.
作者们在一项前瞻性临床试验中研究了戈多克斯疗法对心脏直视手术后止血的影响。37例因瓣膜病接受心脏手术的患者被随机分为对照组（20例）和戈多克斯组（17例）。戈多克斯组的患者按照以下方案给予戈多克斯：麻醉诱导后20分钟内给予200万国际单位，随后以每小时50万国际单位的速度输注直至手术结束。在开始体外循环前，还向氧合器中注入100万国际单位。戈多克斯组术后胸腔引流管引流量较少（534±260毫升对987±583毫升，p＜0.005），该组对供血和新鲜冰冻血浆的需求量也较低（分别为534±633毫升对935±718毫升，p＜0.05；70±153毫升对211±245毫升，p＜0.05）。两组术后活化部分凝血活酶时间、凝血酶原时间、凝血酶时间值之间无显著差异。作者能够证明戈多克斯组术后纤维蛋白原浓度显著升高，纤维蛋白溶解活性显著降低（p＜0.05）。戈多克斯疗法对心脏直视手术后的止血有有利影响，这可以通过临床和实验室检查得到证实。
