Liu B, Belboul A, al-Khaja N, Dernevik L, Raberts D, William-Olsson G
Department of Thoracic and Cardiovascular Surgery, Sahlgrenska Hospital, University of Gothenburg, Sweden.
Chin Med J (Engl). 1991 Dec;104(12):980-5.
Intraoperative high-dose aprotinin during cardiopulmonary bypass was used to investigate if high-risk bleeders could be changed to bleed normally or less as well as see if aprotinin could preserve lung function. Eleven matched controls were compared with eleven aprotinin patients taking warfarin or aspirin preoperatively. The mean (+/- SEM) 12-h and 24-h postoperative amount of bleeding, volume of blood product transfusion and hemoglobin reduction in the aprotinin group were 328 +/- 45 ml, 418 +/- 63 ml, 341 +/- 99 ml and 1.8 +/- 0.5 g% respectively, which were significantly lower than the respective values of 716 +/- 86 ml (P less than 0.01), 1,029 +/- 115 ml (P less than 0.01), 985 +/- 294 ml (P less than 0.05) and 4.1 +/- 0.4 g% (P less than 0.02) in the controls. There was a 65% blood-saving effect by aprotinin in this study. The hypercapnea rate was 45% in the treated patients, and 82% (P less than 0.05) in the controls reflecting better preservation of pulmonary diffusion function which is clinically important following major surgery.
在体外循环期间使用术中高剂量抑肽酶，以研究高危出血者是否能够转变为正常出血或减少出血，并观察抑肽酶是否能够保护肺功能。将11名匹配的对照者与11名术前服用华法林或阿司匹林的抑肽酶治疗患者进行比较。抑肽酶组术后12小时和24小时的平均（±标准误）出血量、血液制品输血量和血红蛋白降低量分别为328±45毫升、418±63毫升、341±99毫升和1.8±0.5克%，这些值显著低于对照组各自的716±86毫升（P<0.01）、1029±115毫升（P<0.01）、985±294毫升（P<0.05）和4.1±0.4克%（P<0.02）。在本研究中，抑肽酶具有65%的节血效果。治疗组患者的高碳酸血症发生率为45%，对照组为82%（P<0.05），这反映出肺弥散功能得到了更好的保护，这在大手术后具有重要的临床意义。
