氨甲环酸对减少心肺旁路心脏手术围手术期引流的效果

Murat Ziya Bağış, Bişar Amaç
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摘要

导言:尽管心肺旁路手术仍是治疗心脏病的重要方法,但它也存在出血等风险。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在减少术中和术后引流量方面的疗效,氨甲环酸是治疗出血的常规药物。方法 这项回顾性研究共纳入了 80 名接受心肺旁路手术的患者。其中,40 名患者在手术过程中接受了氨甲环酸治疗,被归入第一组;40 名患者未接受氨甲环酸治疗,被归入第二组。采用排除标准后,从医院计算机系统和/或档案记录中收集患者数据,并记录在案。然后对数据进行统计分析比较。结果 两组患者的年龄、性别、身高、体重、体表面积、血流量和射血分数百分比、术前血液学参数和术中变量(氨甲环酸除外)相似(P>0.05)。但在术中(通过心肺机)和术后红细胞输注率、术中和术后出血引流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,组间差异有统计学意义(P<0.05)。结论 我们认为,心肺旁路冠状动脉搭桥术患者术中和术后使用氨甲环酸对血液学指标、减少血液制品使用量和出血引流量有积极影响。
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The Efficacy of Tranexamic Acid in Reducing Perioperative Drainage in Cardiac Surgery with Cardiopulmonary Bypass
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.
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