ABSTRACT
Objective To evaluate the blood-saving effect of combination of hemocoagulase artox for injection and tranexamic acid (TXA) in patients undergoing off-pump coronary artery bypass grafting (OPCABG).Methods Eighty ASA Ⅱ patients (NYHA Ⅰ or Ⅱ),aged 50-70 yr,weighing 50-100 kg,scheduled for elective OPCABG,were randomly divided into 4 groups (n =20 each):control group (group C),hemocoagulase atrox for injection group (group H,n =20),TXA group (group T) and hemocoagulase atrox for injection + ·TXA group (group HT).Hemocoagulase atrox 0.04 U/kg (the highest dose 4 U) was injected at 20 min before skin incision,and additional hemocoagulase atrox 2 U was given every 2 h starting from 15 min after administration of protamine until the end of operation in group H.TXA 20 mg/kg was injected intravenously at skin incision,followed by a continuous infusion of TXA at 10 mg· kg-1 · h-1 until the end of operation in group T.Hemocoagulase atrox and TXA were given as the method described in groups H and T.Venous blood samples were taken from the central vein before operation,at the end of operation,and 24 h after operation to determine the plasma D-Dimer concentration.The amount of blood loss,allogeneic red blood cells and plasma infused during operation,volume of drainage during 0-6 and 6-24 h after operation,total volume of drainage and volume of allogeneic blood transfused during operation were recorded.The deep vein thrombosis was recorded.Results Compared with group C,the amount of blood loss during operation was significantly decreased in groups T and HT,and the allogeneic red blood cells and plasma infused during operation,and volume of drainage during 0-6 and 6-24 h after operation,and total volume of drainage were significantly decreased in groups H,T and HT (P ＜ 0.05).Compared with groups H and T,the allogeneic red blood cells and plasma infused during operation,and volume of drainage during 0-6 and 6-24 h after operation,and total volume of drainage were significantly decreased in group HT (P ＜ 0.05).No deep vein thrombosis was observed in the 4 groups.Conclusion The combination of hemocoagulase artox for injection and TXA provides better blood-saving effect than either alone for the patients undergoing OPCABG without increasing the risk for thrombosis.