中国体外循环杂志2025，Vol.23Issue(3)：204-209,6.DOI:10.13498/j.cnki.chin.j.ecc.2025.03.03
比伐卢定用于体外循环心脏手术抗凝病例系列和文献回顾
Bivalirudin for anticoagulation in cardiac surgery with cardiopulmonary bypass:a case series and literature review
卞璐瑜 1闫姝洁 1于坤 1管玉龙 1滕媛 1刘刚 1冯春蕾 2王靖 1吉冰洋1
作者信息
- 1. 100037 北京,中国医学科学院阜外医院体外循科
- 2. 100037 北京,中国医学科学院阜外医院心力衰竭和移植病区
- 折叠
摘要
Abstract
Objective To evaluate the safety and feasibility of bivalirudin used for anticoagulation in cardiac surgery with cardiopulmonary bypass(CPB).Methods Through a retrospective analysis was conducted on clinical data from 5 patients who received bivalirudin anticoagulation during CPB at Fuwai Hospital,combined with a literature review to assess current strategies and unresolved challenges.Results Four patients received bivalirudin anticoagulation due to heparin-induced thrombocytopenia(HIT),while one patient was administered bivalirudin intraoperatively for heparin allergy.Activated clotting time(ACT)during CPB was maintained between 403 and 560 seconds.Postoperatively,ACT returned to<200 seconds within 2.5-19 hours.Chest closure time ranged from 1.5 to 7 hours,and 24-hour postoperative thoracic drainage volume was 290-840 ml.All patients recovered uneventfully without thrombotic events during or after surgery.Conclusion Bivalirudin demonstrates safety and feasibility as an anticoagulant for CPB in cardiac surgery.Despite potential bleeding risk,favorable patient outcomes suggest its viability as an alternative to heparin,particularly in HIT or heparin-allergic cases.关键词
比伐卢定/心肺转流/心脏手术/抗凝/肝素诱导性血小板减少症Key words
Bivalirudin/Cardiopulmonary bypass/Cardiac surgery/Anticoagulation/Heparin-induced thrombocytopenia引用本文复制引用
卞璐瑜,闫姝洁,于坤,管玉龙,滕媛,刘刚,冯春蕾,王靖,吉冰洋..比伐卢定用于体外循环心脏手术抗凝病例系列和文献回顾[J].中国体外循环杂志,2025,23(3):204-209,6.
