Cole C W, Bormanis J, Luna G K, Hajjar G, Barber G G, Harris K A, Brien W F
Department of Surgery, Ottawa Civic Hospital, Ontario, Canada.
J Vasc Surg. 1993 Feb;17(2):288-92; discussion 293. doi: 10.1067/mva.1993.42069.
The purpose of this study was to compare the conduct and early results of infrainguinal vascular reconstructions with use of ancrod or heparin for anticoagulation.
To test the hypothesis that ancrod was an effective alternative to heparin, 28 patients requiring infrainguinal bypass surgery were randomized to receive heparin during operation or ancrod before operation over a period of 12 hours to deplete circulating fibrinogen (0.2 to 0.5 gm/L).
No clotting of blood within the grafts or native vessels was noted during the conduct of the surgical procedures in either group. No excessive bleeding was detected during operation in either group. The operative procedure, complication rate, and hospital course were also indistinguishable; patency at 1 month was also equal.
Fibrinogen depletion with ancrod provides anticoagulation for the conduct of infrainguinal vascular reconstructions that is as effective as heparin. When heparin is contraindicated ancrod is an effective and safe alternative.
本研究旨在比较使用抗栓酶或肝素进行抗凝的股腘动脉血管重建术的实施情况及早期结果。
为验证抗栓酶是肝素有效替代物这一假设，28例需要股腘动脉搭桥手术的患者被随机分组，一组在手术期间接受肝素治疗，另一组在术前12小时接受抗栓酶治疗，以消耗循环中的纤维蛋白原（0.2至0.5克/升）。
两组在手术过程中均未发现移植血管或自身血管内血液凝固。两组在手术期间均未检测到过度出血。手术操作、并发症发生率及住院过程也无明显差异；1个月时的通畅率也相同。
抗栓酶消耗纤维蛋白原可为股腘动脉血管重建术提供与肝素同样有效的抗凝作用。当肝素禁忌时，抗栓酶是一种有效且安全的替代药物。
