中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
10期
1084-1087
,共4页
杨志军%黄瑾%秦家振%戴宜武%徐如祥
楊誌軍%黃瑾%秦傢振%戴宜武%徐如祥
양지군%황근%진가진%대의무%서여상
神经外科手术%注射用血凝酶%凝血功能
神經外科手術%註射用血凝酶%凝血功能
신경외과수술%주사용혈응매%응혈공능
Neurosurgical operation%Baquting%Coagulation function
目的 观察注射用血凝酶在神经外科手术中局部应用的止血效果及对凝血功能的影响.方法 选取我院诊治的60例神经外科手术患者,美国麻醉医师协会(ASA)分级Ⅰ、Ⅱ级,随机分为用药组30例和空白对照组30例.两组术前一天给予注射用血凝酶2U肌肉注射;术前30 min注射用血凝酶2U静脉注射;术后注射用血凝酶2U静脉注射,每天2次,连续用药3d.用药组术中应用注射用血凝酶4U+生理盐水10 ml局部喷洒.比较两组患者的手术视野清晰度、手术出血量、术中输血量、术后引流量,并检测术前及术后凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)定量、纤维蛋白原降解产物(FDP)、D-二聚体和血小板计数(PLT),并于术后进行随访.结果 用药组手术视野有效改善率为70.0％ (21/30),空白对照组手术视野有效改善例数为0,两组比较差异有统计学意义(P＜0.05);用药组术中手术出血量[(680.00±95.22) ml],少于空白对照组[(790.00±47.00) ml],两组比较差异有统计学意义(P=0.034);两组患者术后PLT计数与术前相比均明显减少(P＜0.05或P＜0.01),但两组间相比差异无统计学意(P＞0.05).术后随访两组患者术后恢复好,无不良事件发生.结论 注射用血凝酶局部喷洒用于神经外科手术可改善手术术野清晰度,减少手术出血量;不会影响患者凝血功能,不会增加血栓形成的危险.
目的 觀察註射用血凝酶在神經外科手術中跼部應用的止血效果及對凝血功能的影響.方法 選取我院診治的60例神經外科手術患者,美國痳醉醫師協會(ASA)分級Ⅰ、Ⅱ級,隨機分為用藥組30例和空白對照組30例.兩組術前一天給予註射用血凝酶2U肌肉註射;術前30 min註射用血凝酶2U靜脈註射;術後註射用血凝酶2U靜脈註射,每天2次,連續用藥3d.用藥組術中應用註射用血凝酶4U+生理鹽水10 ml跼部噴灑.比較兩組患者的手術視野清晰度、手術齣血量、術中輸血量、術後引流量,併檢測術前及術後凝血酶原時間(PT)、部分凝血活酶時間(APTT)、纖維蛋白原(FIB)定量、纖維蛋白原降解產物(FDP)、D-二聚體和血小闆計數(PLT),併于術後進行隨訪.結果 用藥組手術視野有效改善率為70.0％ (21/30),空白對照組手術視野有效改善例數為0,兩組比較差異有統計學意義(P＜0.05);用藥組術中手術齣血量[(680.00±95.22) ml],少于空白對照組[(790.00±47.00) ml],兩組比較差異有統計學意義(P=0.034);兩組患者術後PLT計數與術前相比均明顯減少(P＜0.05或P＜0.01),但兩組間相比差異無統計學意(P＞0.05).術後隨訪兩組患者術後恢複好,無不良事件髮生.結論 註射用血凝酶跼部噴灑用于神經外科手術可改善手術術野清晰度,減少手術齣血量;不會影響患者凝血功能,不會增加血栓形成的危險.
목적 관찰주사용혈응매재신경외과수술중국부응용적지혈효과급대응혈공능적영향.방법 선취아원진치적60례신경외과수술환자,미국마취의사협회(ASA)분급Ⅰ、Ⅱ급,수궤분위용약조30례화공백대조조30례.량조술전일천급여주사용혈응매2U기육주사;술전30 min주사용혈응매2U정맥주사;술후주사용혈응매2U정맥주사,매천2차,련속용약3d.용약조술중응용주사용혈응매4U+생리염수10 ml국부분쇄.비교량조환자적수술시야청석도、수술출혈량、술중수혈량、술후인류량,병검측술전급술후응혈매원시간(PT)、부분응혈활매시간(APTT)、섬유단백원(FIB)정량、섬유단백원강해산물(FDP)、D-이취체화혈소판계수(PLT),병우술후진행수방.결과 용약조수술시야유효개선솔위70.0％ (21/30),공백대조조수술시야유효개선례수위0,량조비교차이유통계학의의(P＜0.05);용약조술중수술출혈량[(680.00±95.22) ml],소우공백대조조[(790.00±47.00) ml],량조비교차이유통계학의의(P=0.034);량조환자술후PLT계수여술전상비균명현감소(P＜0.05혹P＜0.01),단량조간상비차이무통계학의(P＞0.05).술후수방량조환자술후회복호,무불량사건발생.결론 주사용혈응매국부분쇄용우신경외과수술가개선수술술야청석도,감소수술출혈량;불회영향환자응혈공능,불회증가혈전형성적위험.
Objective To investigate the hemostatic effect and influence on coagulation function of hemecongulase during neurosurgical operation.Methods Sixty patients with neurosurgical trauma at American statistical association(ASA) Ⅰ-Ⅱ were randomly divided into hemocoagnlase treatment group (n =30) and control group(n =30).Both two group were injected Baquting 2U at the day before the operation,30 min before the operation,every two day after the operation and end up 3 d.Treatment group were pedormed with Baqyting 4 U + physiological saline 10 ml topical spraying.The intelligibility of operating region,the volume of intraoperative,the volume of bleeding during the operation,transfusion of blood,postoperative drainage,and drainage tube exelcymosis time were recorded in all the patients.Prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen level(FIB),fibrinogen degradation product(FDP) and the two D-dimer and platelet count(PLT) before and after the surgery were also determined.All the patients were postoperatively followed up.Results The intelligibility of operating region was 70.0％ (21/30) in the hemocoagnlase treatment group,higher than that in control group (0％,P ＜0.05).The volume of bleeding during the operation in the hemecoagulase treatment group was (680.00 ± 95.22) ml,significantly fewer than that in the control group((790.00 ±47.00) ml,P =0.034).PLT significantly decreased after the surgery in both of the groups compare to that in preoperation (P ＜ 0.05 or P ＜ 0.01) and no significant difference was seen between two groups (P ＞ 0.05).No severe adverse events were found in both groups.Conclusion Hemocoagulase treatment during the operation can improve the intelligibility of operating region,reduce the volume of bleeding and transfusion of blood,and do not affect the coagulation function in the patients.Therefore,hemocoagulase is a safe and effective hemostatic and through local application during the operation it can improve curative effect.
