Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Effects of Aprotinin on Postoperative Bleeding and Blood Coagulation System in Pediatric Open Heart Surgery

소아개심술시 아프로티닌이 술후 출혈 및 혈액응고계에 미치는 영향

  • 신윤철 (서울대학교 의과대학 흉부외과학교실) ;
  • 전태국 (삼성의료원 삼성서울병원 흉부외과, 이화여자대학교 동대문병원 흉부외과, 서울대학교 의과대학 흉부외과학교실, 서울대학교 의과대학 흉부외과학교실)
  • Published : 1996.03.01
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Abstract

From December of 1994 to April of 1995, we, SHUH Department of Pediatric Thoracic and Cardiovascular Surgery, studied effects of aprotinin. 95 patients were randomly divided into two groups : group I (n=47) with aprotinin and group ll (n=48) without aprotinin. Aprotinin was given as one shot injection to cardiopulmonary bypass perfusion solution with dose of 50,000 KIUikg. Laboratory data such as hemoglobin, hematocrit, BUH, creatinine, fibrinogen, electrolyte concentration, aPTT, PT, and AT R was checked preoperatively, 5 minutes after anesthesia, 5 minutes and 35 minutes after CPB circulation, and 5 minutes, 3 hours, and 24 hours after reperfusion. Also, chest-tube drainage, transfused amount of RBC, platelet concentrate, and fresh frozen plasma within first 24 hours postoperatively were checked and analyzed after transition nn body weight demension. Only RBC transfused postoperatively had statistical significance with P value of less than 0.001. Others had no difference statistical wise. Postoperative side effects of aprotinin was not detected weeks after the surgery and there was no reoperated patient due to postoperative bleeding.

1994년 12월부터 1995년 4월까지 서울대학교병원 소아흉부외과에서 개심술을 시행받는 95명의 환아 들을 무작위로 아프로티닌을 쓴 환아군(n=47)과 쓰지않은 환아군(n=48)으로 분류하여 아프로티닌의 효과에 대하여 연구하였다. 아프로티닌은 50,000K/U/kg를 인공심폐기의 충전용액에 단일 투여하였다. 술전, 마취후 5분, 심폐기 관류 5분후, 심폐기 관류 35분후, 재관류 5분후, 재관류 3시간후 및 24시간후에 혈액을 채 취하여 헤모글로빈, 헤마토크릿, BUW, creatinine, 섬유소원, 전해질 농도, 활성 응고시간, 프 로트롬빈 시간, 제3항 트롬빈 등을 측정하였다. 또한 술후 24시간 동안 흥관을 통한 배액 양, 수혈 혈액의 양을 체중으로 나누어 비교하였다. 두 환자군간에 술후 24시간 동안 수혈한 충전 적혈구 양을 제외한 다른 모든 검사에서 통계 학적 의의는 없었으나 아프로티닌의 부작용은 발견되지 않았고 출혈로 인한 재수술도 없었다.

Keywords

References

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