بررسي وجود هپارين تزريق شده حين عمل جراحي عروق در خون بيماران قبل از خنثي كردن آن توسط پروتامين

THE STUDY OF INJECTED HEPARIN EXISTENCE DURING VASCULAR SURGERY IN THE PATIENTS BLOOD BEFORE ITS NUTRALIZATION BY PROTAMINE

Heparine is a anticoagulation substance uscd in vascular surgery to prevent thrombosis during operation and after a while becomes neutralized by protamin an antiheparin drug. Protamine causes some dangerous complications including cardiovascular collapse, anaphilactoid rcation, hypotension, bradycardia and bronchospasm. Using higher doses, also protamin leads to increase anticoagolation effect and results in bleeding. In this prospective study 50 patients candidate of vascular surgery such as ventricular aortic aneurism. aortiebypass , endarterctorny carotid, trauma vascular graft were evaluated using a simple and exact test called activated clotting time (ACT), their coagulation condition before giving heparin as basis (ACT1), and before using protaminc (ACT2) were measured. Heparin dose injected to all patients were 5000 units in this study. difference between ACT1 and ACT2 levels were statistically significant. But a considerablc percentage of patients (44%) had acceptable level of ACT2 although not yet had returned to the base level. In study of relation between the variables, it was observed that ACT2 had significant relationship with duration of injcction between protamine and heparin. When the time is longer, ACT2 will be nearer to ACTI. ACT2 did not have any significant relation with age and weight. We sugest that ACT was measured in all patient before protamin injection if ACT2 was in a acceptable range, the patient would be observed and the bleeding when ocured, protamine should be injected. In this way we donot need injection or inject with lower doses based on the dose of injected heparin in order to prevent dangerous complications of this drug.