Hosseini Habibollah, Rahimianfar Ali Akbar, Abdollahi Mohammad Hassan, Moshtaghiyoon Mohammad Hossein, Haddadzadeh Mahdi, Fekri Asefeh, Barzegar Kazem, Rahimianfar Fatemeh
Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Faculty member at the English Language Department, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Saudi J Anaesth. 2014 Apr;8(2):224-8. doi: 10.4103/1658-354X.130724.
One of the major complications of cardiac surgery is the presence of post-operative bleeding. The aim of the present study was to investigate the topical application of tranexamic acid in the pericardial cavity on post-operative bleeding in off-pump coronary artery bypass graft (CABG) surgery.
This study was on 71 patients who underwent off-pump CABG. The anesthesia and surgery methods were the same for all patients. Patients were assigned to two equal groups. In the first group, 1 g of tranexamic acid in 100 mL of normal saline solution (NSS) was applied to pericardium and mediastinal cavity at the end of surgery. In the second group, only 100 mL of NSS was applied. Chest drainage of the patients after 24 h and the amounts of blood and blood products transfusion were also recorded during this time.
Patients were the same regarding demographic information and surgery. The average volume of blood loss after 24 h was 366 mL for the first group and 788 mL for the control group. There was a statistically significant difference between the two groups (P < 0.001). The amount of packed red blood cells transfusion in the first group was less than that of the control group, which was not statistically significant. There was no statistically significant difference between the amount of hemoglobin, hematocrit, platelets, prothrombin time and partial thromboplastin time in the post-operative stage in the two groups.
The topical application of tranexamic acid in off-pump CABG patients leads to a decreased post-operative blood loss.
心脏手术的主要并发症之一是术后出血。本研究的目的是探讨氨甲环酸在心包腔内局部应用对非体外循环冠状动脉旁路移植术(CABG)术后出血的影响。
本研究纳入71例行非体外循环CABG的患者。所有患者的麻醉和手术方法相同。将患者分为两组,每组人数相等。第一组在手术结束时将1 g氨甲环酸溶于100 mL生理盐水中应用于心包和纵隔腔。第二组仅应用100 mL生理盐水。记录患者术后24小时的胸腔引流量以及在此期间的血液和血液制品输血量。
两组患者的人口统计学信息和手术情况相同。第一组术后24小时平均失血量为366 mL,对照组为788 mL。两组之间存在统计学显著差异(P < 0.001)。第一组的浓缩红细胞输血量少于对照组,但差异无统计学意义。两组术后血红蛋白、血细胞比容、血小板、凝血酶原时间和活化部分凝血活酶时间无统计学显著差异。
氨甲环酸局部应用于非体外循环CABG患者可减少术后失血量。