CAJ | 학술논문

目的：探讨人工合成的抗纤溶药物氨甲环酸对接受经尿道前列腺电切术的患者失血量的影响及其安全性。方法2012年1月—2013年2月行经尿道前列腺电切术的60例患者，随机双盲分为氨甲环酸组（ T组）和空白对照组（ C组），每组30例。 T组在麻醉诱导后将氨甲环酸注射液1 g／200 mL（以20～40滴／min的速度）静滴完毕。 C组给予等量生理盐水同样的速度静滴完毕。比较两组术中、术后4 h、术后24 h的失血量，比较两组术前、术后4h凝血功能（凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、纤维蛋白原）的变化，观察术后7d内是否有下肢深静脉血栓或肺栓塞等并发症的发生。结果 T组术中失血量（102．0±11．4） mL及术后4 h的失血量（61．9±6．1）mL明显少于C组术中失血量（303．6±24．8）mL及术后4 h的失血量（84．8±15．2）mL，差异有显著性意义（P＜0．05）。而两组术后24 h失血量比较差异无显著性意义。两组患者凝血指标的比较差异无显著性意义且两组患者均未发现下肢深静脉血栓或肺栓塞等并发症的发生。结论氨甲环酸可以明显降低经尿道前列腺电切术术中及术后4h的失血量，且未增加血栓形成的风险。
목적：탐토인공합성적항섬용약물안갑배산대접수경뇨도전렬선전절술적환자실혈량적영향급기안전성。방법2012년1월—2013년2월행경뇨도전렬선전절술적60례환자，수궤쌍맹분위안갑배산조（ T조）화공백대조조（ C조），매조30례。 T조재마취유도후장안갑배산주사액1 g／200 mL（이20～40적／min적속도）정적완필。 C조급여등량생리염수동양적속도정적완필。비교량조술중、술후4 h、술후24 h적실혈량，비교량조술전、술후4h응혈공능（응혈매원시간、활화부분응혈활매시간、응혈매시간、섬유단백원）적변화，관찰술후7d내시부유하지심정맥혈전혹폐전새등병발증적발생。결과 T조술중실혈량（102．0±11．4） mL급술후4 h적실혈량（61．9±6．1）mL명현소우C조술중실혈량（303．6±24．8）mL급술후4 h적실혈량（84．8±15．2）mL，차이유현저성의의（P＜0．05）。이량조술후24 h실혈량비교차이무현저성의의。량조환자응혈지표적비교차이무현저성의의차량조환자균미발현하지심정맥혈전혹폐전새등병발증적발생。결론안갑배산가이명현강저경뇨도전렬선전절술술중급술후4h적실혈량，차미증가혈전형성적풍험。
Objective To determine the effect of tranexamic acid on perioperative blood loss in patients who underwent transurethral resection of the prostate ( TURP) , as well as its safety.Methods A double blind randomized control trial was conducted from January 2012 to February 2013.In this trial, 30 patients of the tranexamic acid group (T group), between age of 55-85 years, underwent TURP and received 1 g of tranexamic acid in 200 mL normal saline after induction of anes-thesia and 30 patients of the control group (C group) received a placebo (normal saline only).The medicine dripping speed ranged 20-40 drops/minute.The amount of blood loss was measured during the operation and at 4 h and 24 h post-operatively and the difference between the two groups was analyzed.Coagulation profiles, including prothrombin time, thrombin time and fibrinogen level, were measured preoperatively and 4 h postoperatively.Any signs of thromboembolic e-vent especially in the lower limbs or within 7 days were noted.Results The blood losses during operation and 4 h postopera-tion were (102.0 ±11.4) mL and (61.9 ±6.1) mL, respectively in the T group and (303.6 ±24.8) mL and (84.8 ± 15.2) mL, respectively in the C group.The values were significantly lower in the T group compared to those in the C group (P<0.05).However, there was no significant difference at 24 h postoperative blood loss between the groups.The coagu-lation profiles in the two groups were statistically not relevant.There was no evidence of deep vein thrombosis in the lower limbs or in both groups.Conclusion Tranexamic acid can reduce intraoperative blood loss during TURP without increasing the risk of thrombosis.