2025 年第 1 期 第 0 卷

猪源纤维蛋白粘合剂在冠状动脉旁路移植术中的应用研究

Study on the application of porcine fibrin adhesive in coronary artery bypass grafting

作者：徐晓宇1 贾天宇2 李扬2 董然2 林阳1

英文作者：Xu Xiaoyu1 Jia Tianyu2  Li Yang2 Dong Ran2 Lin Yang1

单位：1首都医科大学附属北京安贞医院药事部，北京100029；2首都医科大学附属北京安贞医院冠心病外科中心，北京100029

英文单位：1Department of Pharmacy Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Coronary Surgery Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：冠状动脉旁路移植术；  猪源纤维蛋白粘合剂；  有效性；  安全性；  经济性

英文关键词：Coronaryarterybypassgrafting;  Porcinefibrinsealant;  Efficacy;  Safety;  Economic

• 摘要：

• 目的  评估猪源纤维蛋白粘合剂在冠状动脉旁路移植术（CABG）中的有效性、安全性以及经济性。方法  回顾性分析2023年3—10月于首都医科大学附属北京安贞医院冠心病外科中心143例接受非停跳CABG患者的临床资料，其中67例患者术中使用了猪源纤维蛋白粘合剂（观察组），76例患者术中未使用（对照组）。分析2组重症监护病房（ICU）停留时间、术后引流量、引流管留置时间、术后住院时间、术后血液制品使用率、凝血功能及药物过敏发生情况。结果  2组ICU停留时间、术后引流量、术后血液制品使用率比较差异均无统计学意义（均P＞0.05）。观察组术后引流管留置时间以及住院时间均短于对照组［44（38,49）h比46（41,65）h、5（4,6）d比5（5,6）d］（均P＜0.05）。术前及术后第1天，2组凝血酶原活动度、活化部分凝血活酶时间、纤维蛋白原水平比较差异均无统计学意义（均P＞0.05）。术后第1天，观察组纤维蛋白降解产物水平高于对照组（P＜0.05）。2组均未发生药物相关过敏反应，住院费用比较差异无统计学意义（P＞0.05）。结论  CABG术中使用猪源纤维蛋白粘合剂具有良好的生物相容性，可缩短患者术后引流管留置时间及术后住院时长，但并不会减少术后引流量及输血率，对患者住院费用也无明显影响。

• Objective  To evaluate the efficacy, safety and economy of porcine fibrin sealant in coronary artery bypass grafting (CABG). Methods   The clinical data of 143 patients who underwent off-pump CABG in the Coronary Surgery Center, Beijing Anzhen Hospital, Capital Medical University from March to October 2023 were retrospectively analyzed. Among them, 67 patients were treated with porcine fibrin adhesive during the operation (observation group), and 76 patients were not treated (control group). The intensive care unit (ICU) stay time, postoperative drainage volume, drainage tube indwelling time, postoperative hospital stay, postoperative blood product usage rate, coagulation function and drug allergy were analyzed. Results   There was no significant difference in ICU stay time, postoperative drainage volume and postoperative blood product usage between the two groups (all P>0.05). The postoperative drainage tube indwelling time and hospitalization time of the observation group were shorter than those of the control group ［44(38,49)h vs 46 (41,65)h, 5(4,6)d vs 5(5,6)d］(both P<0.05). There was no significant difference in prothrombin activity, activated partial thromboplastin time and fibrinogen level between the two groups before operation and on the first day after operation (all P>0.05). On the first day after operation, the level of fibrin degradation products in the observation group was higher than that in the control group (P<0.05). There was no drug-related allergic reaction in the two groups, and there was no significant difference in hospitalization costs between the two groups (P<0.05). Conclusion   The use of porcine fibrin adhesive during CABG has good biocompatibility, which can shorten the postoperative drainage tube indwelling time and postoperative hospital stay, but does not reduce the postoperative drainage volume and blood transfusion rate, and has no significant effect on the hospitalization cost of patients.