氨甲环酸对体外循环冠脉旁路移植术围术期白介素－6及 C反应蛋白的影响

摘要

目的：评价氨甲环酸对体外循环冠脉旁路移植术围术期白素－6及 C 反应蛋白的影响。方法选择60例择期行体外循环下冠脉旁路移植术的患者，年龄44－71岁，体重指数17－23kg／m2。ASA 分级Ⅰ－Ⅲ，随机分为两组：氨甲环酸组（T 组）和对照组（C 组），每组30例。T 组患者采用诱导完成后给予氨甲环酸负荷剂量15mg／kg，10分钟内推注完成后以500mg／h 的速率持续输注到手术结束。C 组给予等量的生理盐水。分别于麻醉诱导前、关胸前和术后24小时经中心静脉抽取静脉血测定 CRP、IL －6和 D －二聚体。并记录术中出血量，术后12小时，24小时的胸腔引流量。记录手术期间并发症等情况。结果与 C 组相比，T 组的术后24小时 CRP，IL －6，术后胸腔引流量均较 C 组为低，围术期两组未发生相关并发症。结论氨甲环酸可以减轻体外循环冠脉旁路移植术围术期炎性反应。%Objective evaluation of tranexamic acid on of -pump coronary artery bypass grafting peri operation period of interleukin -6 and C reactive protein influence.Methods 60 ca-ses of patients undergoing of -pump coronary artery bypass grafting,aged 44 to 71 years old,a BMI of 17 -23kg/m2.ASA grade I -III,were randomly divided into two groups:tranexamic acid group(T group)and control group(C group),30 cases in each group.Adopting T group patients after the completion of induction give ammonia tranexamic acid loading dose of 15 mg /kg,10 minutes push completion of injection to 500mg/h the rate of continuous infusion to the end of operation.C group was given equal volume of normal saline.Venous blood was extracted from CRP,IL -6 and D -two bodies at the central venous blood before and after anesthesia induction,respectively.And recorded the volume of blood loss,postoperative 12 hours,24 hours of thoracic drainage.Recorded during surgery complications.Results compared with C group,T group 24 hours after CRP,IL -6,pleuraldrainage were lower than C group is low.During the perio-perative period of two groups with no complications.Conclusion tranexamic acid can reduce cardiopulmonary bypass coronary artery bypass graft surgery perioperative inflammatory response.