膈上主动脉钳夹对肝素抗凝作用的影响。

The effects of supraceliac aortic clamping on the anticoagulant effects of heparin.

作者信息

Money S R, Ballinger B A, Crockett D E, Chatman D M, Lohmann T P

机构信息

Department of General Surgery, Alton Ochsner Medical Institutions, New Orleans, Louisiana, USA.

出版信息

Am J Surg. 1996 Aug;172(2):155-7. doi: 10.1016/S0002-9610(96)00140-7.

DOI:10.1016/S0002-9610(96)00140-7

PMID:8795520

Abstract

BACKGROUND

Coagulopathy is frequently encountered during supraceliac aortic clamping. Patients are routinely heparinized during these operations. This experiment was undertaken to evaluate the effect of supraceliac aortic cross-clamping (XC) on heparin pharmacodynamics.

MATERIAL AND METHODS

Fourteen mongrel dogs were randomly divided into three groups: Group 1 (X; n = 6), 90 minutes aortic XC; Group 2 (SH; n = 4), sham operation and heparin, 100 mg/kg intravenously; and Group 3 (XH; n = 4), heparin, 100 mg/kg intravenously 3 minutes before XC. Prothrombin time (PT) and partial prothrombin time (PTT) were measured serially. Heparin concentrations were estimated via automated titration with protamine sulfate.

RESULTS

After XC, PTT is increased during reperfusion. Heparin administration (XH) before aortic XC increases PTT above those with X or SH. Anticoagulation was potentiated and prolonged by XC. There was no difference in heparin concentration or PT.

CONCLUSION

Supraceliac aortic clamping significantly affects heparin pharmacodynamics and may contribute to coagulopathy.

摘要

背景

在腹主动脉上段钳夹期间经常会出现凝血功能障碍。在这些手术过程中患者通常会接受肝素化处理。本实验旨在评估腹主动脉上段交叉钳夹（XC）对肝素药效学的影响。

材料与方法

14只杂种犬被随机分为三组：第1组（X组；n = 6），进行90分钟的主动脉XC；第2组（SH组；n = 4），假手术并静脉注射100 mg/kg肝素；第3组（XH组；n = 4），在XC前3分钟静脉注射100 mg/kg肝素。连续测量凝血酶原时间（PT）和部分凝血活酶时间（PTT）。通过用硫酸鱼精蛋白自动滴定法估算肝素浓度。