The Clinical Observation Of Tranexamic Acid On Valve Replacement Operation Under Cardiopulmonary Bypass

Objective: To explore the effect of tranexamic acid (tranexamic acid, TA) oncoagulation funtion, volumn of blood loss and transfusion during the perioperative period ofvalve replacement surgery under cardiopulmonary bypass.Methods: One hundred and twenty ASA II~III patients undergoing valvularreplacement surgery under cardiopulmony bypass (CPB) from June of2011to March of2013were randomly divided into Not Tranexamic Acid (groupNTA) and Tranexamic Acid(groupTA). The groupTA (n=60) were totally given2g（100ml）of tranexamic acid.1g (100ml) was given by intravenous drip after anesthesia induction before cutting skin and1g(100ml) was given after the heparin neutralization. groupNTA(n=60) was given the samedose of saline at the same time. The value of hemoglobin, hematokrit before the operation,before CPB downtime, the end of operation and12h after the operation were recorded; thevalue of ACT before, during and after the period of CPB were recorded; Preoperative andpostoperative blood coagulation four indices of PT, APTT, INR, FIB were recorded; and theCPB time, the aortic cross clamp time, operation time, intraoperative blood product input,pericardium and mediastinal drainage12h after surgery were also recorded.Results: There was no significant difference of general information between two groups(P>0.05). Compared with groupNTA, the Hb and Hct value of groupTA were significantlyhigher at the time of12h after surgery (P <0.05), the Hb and Hct value of two groups aftersurgery were both lower than the value before surgery(P <0.05). Four coagulation indexes(PT, APTT, INR, FIB) of two groups after surgery were higher than the value before surgery(P <0.05). Compared with groupNTA, the PT and INR value of groupTA was lower (P < 0.01). There was no significant difference of ACT value before, during and after CPBbetween two groups (P>0.05). Compared with groupNTA, intraoperative blood productinput, pericardium and mediastinal drainage of groupTA was significantly decreased (P <0.01).Conclusion: Tranexamic acid used in valve replacement surgery under cardiopulmonarybypass can effectively reduce the intraoperative and postoperative blood loss and decrease theblood products demand. Tranexamic acid can protect the clotting factors in cardiopulmonybypass surgery.