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氨甲环酸在体外循环心脏手术中减少围手术期引流的效果。

The Efficacy of Tranexamic Acid in Reducing Perioperative Drainage in Cardiac Surgery with Cardiopulmonary Bypass.

机构信息

Clinic of Cardiovascular Surgery, Health Sciences University, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey.

Department of Perfusion, Health Sciences University, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey.

出版信息

Braz J Cardiovasc Surg. 2024 Apr 17;39(3):e20230181. doi: 10.21470/1678-9741-2023-0181.

Abstract

INTRODUCTION

Although cardiopulmonary bypass procedures remain a critical treatment option for heart disease, they come with risks, including hemorrhage. Tranexamic acid is known to reduce morbidity and mortality in surgical hemorrhage.

OBJECTIVE

This study aimed to evaluate the efficacy of tranexamic acid, which is routinely used to treat hemorrhage, in decreasing the amount of intraoperative and postoperative drainage.

METHOD

A total of 80 patients who underwent cardiac surgery with cardiopulmonary bypass were included in this retrospective study. Forty patients who received tranexamic acid during the operation were assigned to Group 1, while 40 patients who did not receive tranexamic acid were assigned to Group 2. Patient data were collected from the hospital computer system and/or archive records after applying exclusion criteria, and the data were recorded. Statistical analyses were then performed to compare the data.

RESULTS

Age, sex, height, weight, body surface area, flow, and ejection fraction percentages, preoperative hematological parameters, and intraoperative variables (except tranexamic acid) were similar between the groups (P>0.05). However, there were statistically significant differences between the groups in terms of intraoperative (through the heart-lung machine) and postoperative red blood cell transfusion rates, intraoperative and postoperative bleeding drainage amounts, as well as postoperative hematocrit, hemoglobin, platelet, and red blood cell levels (P<0.05).

CONCLUSION

We concluded that intraoperative and postoperative use of tranexamic acid in patients who underwent coronary artery bypass grafting with cardiopulmonary bypass has positive effects on hematological parameters, reducing blood product use, and bleeding drainage amount.

摘要

简介

虽然体外循环程序仍然是心脏病的重要治疗选择,但它们存在风险,包括出血。氨甲环酸可降低手术出血的发病率和死亡率。

目的

本研究旨在评估氨甲环酸(一种常规用于治疗出血的药物)的疗效,以减少术中及术后引流的血量。

方法

这项回顾性研究共纳入 80 例行体外循环心脏手术的患者。40 例术中使用氨甲环酸的患者被分配到第 1 组,40 例未使用氨甲环酸的患者被分配到第 2 组。应用排除标准后,从医院计算机系统和/或档案记录中收集患者数据,并记录数据。然后进行统计分析以比较数据。

结果

两组患者的年龄、性别、身高、体重、体表面积、流量和射血分数百分比、术前血液学参数以及术中变量(除氨甲环酸外)相似(P>0.05)。然而,两组在术中(通过心肺机)和术后红细胞输注率、术中及术后出血量、以及术后血细胞比容、血红蛋白、血小板和红细胞水平方面存在统计学显著差异(P<0.05)。

结论

我们的结论是,体外循环下冠状动脉旁路移植术中及术后使用氨甲环酸对血液学参数有积极影响,减少了血液制品的使用和出血量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7c5/11021030/8ac2c14f2796/bjcvs-39-03-e20230181-g01.jpg

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