The Effect of Postoperative Tranexamic Acid and Its Combination with Hemocoagulase Agkistrodon in Patients Undergoing Heart Valve Replacement:A Retrospective Cohort Study
OBJECTIVE To compare the effectiveness and safety of postoperative tranexamic acid(TXA)and its combination with hemocoagulase agkistrodon(HA)in patients undergoing cardiac valve replacement with cardiopulmonary bypass(CPB).METHODS This was a retrospective study of patients receiving TXA with 1 g during the intraoperative period between January 1,2018 and December 31,2019.According to the postoperative administration of hemostatic agents,the patients were assigned to the control group(Group C),the TXA group(Group T)and TXA's combination with HA group(Group TH).The clinical outcomes included the blood loss,transfusion of blood products,the overall pericardial drainage volume,days of pericardial drainage(days),length of intensive care unit(ICU)stay(hours),duration of mechanical ventilation(hours),days of postoperative hospitalization(days),coagulation function,hepatic function,the incidences of thromboembolic events and human fibrinogen transfusion events.RESULTS Among three groups,there were no significant differences in the blood loss,transfusion of blood products,duration of mechanical ventilation,days of postoperative hospitalization,hepatic function,and the incidence of thromboembolic events.Increased total pericardial drainage volume[910.00(700.00-1 250.00)mL]and days of pericardial drainage[6.00(4.00-7.00)days]were found in Group TH compared with Group C[660.00(510.00-815.00)mL;4.00(4.00-6.00)days]and T[580.00(426.50-827.50)mL;4.00(4.00-5.18)days](P＜0.001).Group TH had longer length of ICU stay[22.00(18.30-40.60)days]than Group T[18.90(17.85-34.10)days](P＜0.05).Moreover,lower fibrinogen levels and corresponding higher frequency of human fibrinogen transfusion were found in Group TH,as compared to those in Groups C and T(P＜0.001).CONCLUSION Bleeding events after cardiac valve replacement with CPB are not improved by postoperative administration of additional TXA and the combination with HA.HA is probably related to hypofibrinogenemia and increased transfusions of human fibrinogen.
万方数据
维普
