Clinical research of reptilase combined with hypervolemic hemodilufion and controlled hypoteusion used in tumor surgery

Abstract

Objective To investigate the safety and efficacy of reptilase combined with hypervolemic hemodilution and coutrolled hypotension used in tumor surgery. Methods 60 ASA Ⅰ - Ⅱ selected patients of tumor surgery were randomly allocated to three groups, group A: reptilase 2 000 U introvenous push before operation, 60 g/L HES(15 ml/kg) infused after induction of anesthesia, and nimodipine was used to maintain mean arterial pressure(MAP) between 60 mm Hg-65 mm Hg; group B, nimodipine was used to maintain MAP between 60 mm Hg-65 man Hg; group C, reptilase 2 000 U introvenous push before operation. HR, MAP, CVP, SpO2 and ECG were continuously monitored throughout operation. Arterial and central venous blood samples were taken for determination of Hb, Hct, PLT, FIB, APTT, PT, Posm and LA at T0 (baseline), T1 (onset of operation) , T2 (1 hour after operation) , T3 (completion of operation) respectively. The volume of blood loss and transfusion were recorded during operation in all patients. Results The value of Hb ,Hct in group A was obviously lower than that in goup B and in group C at T1 and the difference reached statistical significance(P 0. 05). The volume of blood loss and blood transfusion in group A were significantly less than that in goup B and C (P < 0.05 or P < 0.01). Conclusion Reptilase combined with hypervolemic hemodilution and controlled hypotensiou used in tumor surgery could effectively decrease the volume of blood loss during operation with relatively stable hemodynamics and mild side effects, and could be generalized in chnical use. Key words: Reptilase; Hemedilution; Controlled hypotensiou; Carcinoma