Boonstra P W, Gu Y J, Akkerman C, Haan J, Huyzen R, van Oeveren W
Thorax Centre, University Hospital of Groningen, The Netherlands.
J Thorac Cardiovasc Surg. 1994 Jan;107(1):289-92.
Heparin coating of an extracorporeal circuit for cardiopulmonary bypass improves the hemocompatibility of the circuit and reduces the inflammatory response of the body. It has not been established, however, that heparin coating also improves postoperative hemostasis. We therefore performed a study in 30 patients who underwent a routine coronary artery bypass graft operation subjected to cardiopulmonary bypass with an uncoated (control) or a heparin-coated extracorporeal circuit (Duraflo II). We found significantly higher plasma levels of heparin in the Duraflo II group. However, we found no significant differences between the two groups with regard to other parameters of activation of the fibrinolytic and coagulation systems and to activation of platelets. Postoperative blood loss and donor blood transfusions were reduced in the Duraflo II group but not to a statistically significant extent. We conclude that heparin coating of an extracorporeal circuit improves anticoagulation but does not significantly reduce platelet activation, fibrinolysis, postoperative blood loss, and donor blood transfusions in routine coronary bypass operations.
用于体外循环的体外循环回路肝素涂层可改善回路的血液相容性并降低机体的炎症反应。然而,肝素涂层是否也能改善术后止血尚未明确。因此,我们对30例行常规冠状动脉旁路移植术并接受未涂层(对照组)或肝素涂层体外循环回路(Duraflo II)体外循环的患者进行了一项研究。我们发现Duraflo II组的血浆肝素水平显著更高。然而,在纤溶和凝血系统激活的其他参数以及血小板激活方面,我们未发现两组之间存在显著差异。Duraflo II组的术后失血量和异体输血减少,但未达到统计学显著程度。我们得出结论,在常规冠状动脉搭桥手术中,体外循环回路的肝素涂层可改善抗凝,但不能显著降低血小板激活、纤维蛋白溶解、术后失血量和异体输血。