Esfandiari Bakhtiari Rostam, Bistgani Mohammad Moazeni, Kabiri Majid
Department of Cardiothoracic Surgery, Faculty of Medicine, Shahr-e-kord University of Medical Sciences, Shahr-e-kord, Iran.
Asian Cardiovasc Thorac Ann. 2013 Dec;21(6):669-74. doi: 10.1177/0218492312466391. Epub 2013 Jul 9.
This study investigated the effects of low-dose tranexamic acid on post-coronary artery bypass surgery bleeding.
Diffuse microvascular bleeding is still a common problem after cardiac procedures. This study was designed to evaluate the hemostatic effects of low-dose tranexamic acid in on-pump coronary artery bypass graft surgery.
In this prospective randomized placebo-controlled study, 150 patients who were candidates for coronary artery bypass were enrolled and randomly assigned to 1 of 2 groups (tranexamic acid or placebo). Total drainage volume and the need for transfusion as well as surgical complications were recorded and compared in the 2 groups.
There was significantly less mediastinal chest tube drainage up to 48 h in the tranexamic acid group (432 ± 210 mL) compared to the placebo group (649 ± 235 mL, p = 0.006). In the placebo group, 43 (58%) patients were given allogeneic blood during hospital stay compared to 22 (25%) in the tranexamic acid group (p < 0.001). No significant difference in postoperative complications was seen.
The use of low-dose tranexamic acid can significantly reduce blood loss and need for transfusion, with no increase in complications.
本研究调查低剂量氨甲环酸对冠状动脉搭桥术后出血的影响。
弥漫性微血管出血仍是心脏手术后常见的问题。本研究旨在评估低剂量氨甲环酸在体外循环冠状动脉搭桥手术中的止血效果。
在这项前瞻性随机安慰剂对照研究中，150例有冠状动脉搭桥指征的患者入组并随机分为两组（氨甲环酸组或安慰剂组）。记录并比较两组的总引流量、输血需求以及手术并发症。
与安慰剂组（649±235 mL，p = 0.006）相比，氨甲环酸组在48小时内纵隔胸管引流量显著减少（432±210 mL）。在安慰剂组，43例（58%）患者在住院期间接受了异体输血，而氨甲环酸组为22例（25%）（p < 0.001）。术后并发症未见显著差异。
使用低剂量氨甲环酸可显著减少失血和输血需求，且不增加并发症。
