CAJ | 학술논문

目的确定尖吻蝮蛇血凝酶注射液(HCA)抑制纤维支气管镜肺活检出血的半数有效剂量(ED50).方法择期行纤维支气管镜肺活检患者,年龄45 ～ 75岁,性别不限,BMI 19 ～ 24 kg/m2,ASA分级Ⅰ或Ⅱ级.常规麻醉后行纤维支气管镜肺活检术,HCA用生理盐水稀释至5ml,取活检组织前2min局部注射,初始剂量1.4 U,根据镜下活检创面出血情况,采用序贯法确定其剂量,有出血时下一例上调一级浓度,否则下调一级浓度,相邻浓度比值为1.2.计算其ED50及其95％可信区间.结果 HCA抑制纤维支气管镜肺活检出血的ED50为0.9U,其95％可信区间为0.7～1.1 U.结论 HCA抑制纤维支气管镜肺活检出血的ED50为0.9U.
목적 학정첨문복사혈응매주사액(HCA)억제섬유지기관경폐활검출혈적반수유효제량(ED50).방법 택기행섬유지기관경폐활검환자,년령45 ～ 75세,성별불한,BMI 19 ～ 24 kg/m2,ASA분급Ⅰ혹Ⅱ급.상규마취후행섬유지기관경폐활검술,HCA용생리염수희석지5ml,취활검조직전2min국부주사,초시제량1.4 U,근거경하활검창면출혈정황,채용서관법학정기제량,유출혈시하일례상조일급농도,부칙하조일급농도,상린농도비치위1.2.계산기ED50급기95％가신구간.결과 HCA억제섬유지기관경폐활검출혈적ED50위0.9U,기95％가신구간위0.7～1.1 U.결론 HCA억제섬유지기관경폐활검출혈적ED50위0.9U.
Objective To determine the median effective dose (ED50) of hemocoagulase agkistrodon (HCA) inhibiting the bleeding after trans-bronchial lung biopsy (TBLB).Methods ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 45-75 yr,body mass index 19-24 kg/m2,scheduled for elective TBLB,were enrolled in this study.TBLB was performed after routine anesthesia.HCA diluted in normal saline 5 ml was locally injected into the biopsy site at 2 min before surgery.The initial dose of HCA was 1.4 U.The dose of HCA was determined by up and down sequential method.Each time the dose of HCA increased/decreased in the next patient depending on whether nor not the bleeding was observed in the biopsy wound under fiberoptic bronchoscope.The ratio between the two successive concentrations was 1.2.The ED50 and 95 ％ confidence interval of HCA were calculated by Dixon's up-and-down method.Results ED50 of HCA inhibiting the bleeding after TBLB was 0.9 U,and 95 ％ confidence interval was 0.7-1.1 U.Conclusion ED50 of HCA inhibiting the bleeding after TBLB is 0.9 U.