The Research Of Prophylatic Admistration Epsilon Aminocaproic Acid To Minimize Postoperative Bleeding For Patients Undergoing Valve Replacement

[Objective] To investigate the hemostasia effect, the influence to the renal function and the possibility thromboembolism of epsilon-aminocaproic acid (EACA) for patients undergoing prosthetic valve replacement. [Methods] 79 patients undergoing prosthetic valve replacement were randomly divided to 2 groups: EACA group (39cases), aprotinin group (40cases). Keeping the same anesthesia, cardiopulmonary bypass and myocardium preserve, the two groups were given EACA and aprotinin separately during valve replacement procedure. Postoperative drainage, amount of infused serum and red blood cell are recorded. The concentration of serum D-dimer and a₂-antiplasmin were measured in three different moment : pre-operation, the moment aorta clamp opened and 72hours after operation. Serum creatinum pre-operation and 72hours after operation were measured.[Result] 1. The post-operative drainage/BSA in EACA group within 12 hours ,12hours to 24 hours and within 24hours were 151.70±76.08 ml/m²,66.82±31.49 ml/m2,218.52±91.92 ml/m2 respectively. In the Aprotinin group, The post-operative drainage/BSA within 12 hours ,12hours to 24 hours and within 24hours were 106.87±104.75ml/m2, 47.02±27.22 ml/m2, 153.89 ± 112.09 ml/m2 respectively. The statistical significant do existed between the two groups in each moment (p<0.05). 2.The average consumption of red blood cell was 3.65±1.76U in EACA group and 3.19±1.94U in Aprotinin group. There was no statistical significant between them. 3. The pre-opertation concentration of D-dimer was 0.88±0.38ug/L in EACA and 0.87±0.52ug/L in Aprotinin group. No statistical significant was found. The concentration of D-dimer when aorta clamp opened was 0.19±0.04 ug/L in EACA group and 0.48±0.11ug/L in Aprotinin group. The statistical significant do existed between the two groups after the aorta clamp opened (p <0.05). 4.No statistical significant existed between the two groups in 72 hours change in creatinine clearance (ACrCl72) and the percent of 72 hours change in creatinine clearance ( %ACrCl72) . 5. No thromboembolism was found in each group. [Conclusion] The hemostasia effect of aprotinin is surpass than that of EACA, but there was no different in the consumption of red blood cell between the two groups. EACA with the dose of 50mg/Kg is equal to the half dose protocol aprotinin in the antifiberlytic action. Both drugs have the same influence to the creatinine clearance.