Fraedrich G, Weber C, Bernard C, Hettwer A, Schlosser V
Department of Cardiovascular Surgery, University Hospital, Freiburg, FRG.
Thorac Cardiovasc Surg. 1989 Apr;37(2):89-91. doi: 10.1055/s-2007-1013914.
Reduction of homologous blood requirement in cardiac surgery is of increasing interest and may be achieved by various technical and pharmacological means. High-dose aprotinin (about 840 mg, equivalent to 6 million Kallikrein inactivator units), a serine proteinase inhibitor, was administered during open heart surgery to 60 patients refusing homologous blood transfusions or suspected to have an increased risk of bleeding. As a significant decrease in donor blood requirement could be observed, a prospective, randomised double blind study in 80 male patients undergoing primary coronary surgery with high-dose aprotinin administration was performed. Mean blood loss was reduced by 45.9% (652 ml in the treated vs 1204 ml in the untreated group, p less than 0.01) and the mean amount transfused was decreased by 74.2% (242 ml vs 937 ml, p less than 0.01). No homologous blood was needed in 57.9% of the aprotinin-treated patients and in 31.6% of patients not treated with aprotinin.
减少心脏手术中对同源血的需求日益受到关注，可通过多种技术和药理学方法实现。高剂量抑肽酶（约840毫克，相当于600万激肽释放酶抑制单位），一种丝氨酸蛋白酶抑制剂，在心脏直视手术期间给予60例拒绝接受同源输血或疑似出血风险增加的患者。由于观察到供体血需求显著减少，因此对80例接受高剂量抑肽酶治疗的初次冠状动脉手术男性患者进行了一项前瞻性、随机双盲研究。平均失血量减少了45.9%（治疗组为652毫升，未治疗组为1204毫升，p<0.01），平均输血量减少了74.2%（242毫升对937毫升，p<0.01）。57.9%接受抑肽酶治疗的患者和31.6%未接受抑肽酶治疗的患者不需要同源血。
