摘要
目的观察注射用血凝酶(巴曲亭)预防和治疗髋关节置换术患者围术期出血的效果,并探讨其对机体凝血功能的影响,为临床合理使用注射用血凝酶提供一定的客观依据。方法80例美国麻醉医师协会(ASA)评分Ⅰ～Ⅱ级择期髋关节置换术患者随机分为两组,每组40例,Ⅰ组(对照组)于术前10min静脉注射等渗盐水4ml,肌肉注射等渗盐水2ml;Ⅱ组(注射血凝酶组)于术前10min静脉注射注射用血凝酶2kU,肌肉注射注射用血凝酶1kU,分别测定术中及术后出血量,并于术中、术毕、术后第1,5天检测相关凝血功能指标。结果(1)Ⅱ组患者术中及术后出血量均明显少于Ⅰ组患者(术中P<0.01,术后P<0.05);(2)活化部分凝血活酶时间(APTT)值术毕及术后1dⅡ组患者较Ⅰ组患者明显缩短(P<0.01);活化部分凝血酶原活动度[APTT(A)]值术毕Ⅱ组患者较Ⅰ组患者明显增高(P<0.01);纤维蛋白原(Fbg)值术后1dⅡ组患者较Ⅰ组明显降低(P<0.01);其余指标各时间点两组患者间差异均无显著性意义。结论术前预防性使用注射用血凝酶能明显减少术中及术后出血。使用注射用血凝酶后可在术中一过性地改善部分凝血功能,术后恢复正常,提示术前预防性使用注射用血凝酶不会增加术后血栓形成的风险。
Objective To investigate the effects of hemocoagulase in preventing and treating perioperative hemorrhage in patients undergoing total hip replacement and study its effects on perioperative blood coagulation function so as to provide objective basis for better clinical usage of hemocoagulase. Methods Eighty ASA Ⅰ Ⅱ patients undergoing total hip replacement under general anesthesia were randomly and equally divided into two groups, ie, Group Ⅰ (control group) that received normal saline for 4 ml iv and normal saline for 2 ml im 10 minutes preoperatively; GroupⅡ(hemocoagulase group) that received hemocoagulase for 2 kU iv and Hemocoagulase for 1 kU im 10 minutes preoperatively. The perioperative and postoperative bleeding volume was measured respectively; meanwhile, the indices of blood coagulation function were measured during operation, immediately, one and five days after operation. Results (1) The perioperative and postoperative bleeding volume in GroupⅡ was significantly less than that in Group Ⅰ ( P <0.01 during operation and P < 0.05 after operation); (2) Activated partial thromboplastin time (APTT) in GroupⅡ was significantly shorter than that in Group Ⅰimmediately and one day after operation ( P < 0.01); APTT (A) was increased significantly in GroupⅡ immediately after operation compared with that of Group Ⅰ ( P < 0.01 ); fibrinogen in Group Ⅱ decreased more significantly at day 1 after operation than that in Group Ⅰ ( P < 0.01 ). There were no significantly differences in other indices in both groups. Conclusions Bleeding during and after operation can be reduced by preoperatively using hemocoagulase that can attain a transient improvement in perioperative blood coagulation function that then can recover to normal postoperatively, as indicating that preoperative usage of hemocoagulase can not result in postoperative thrombosis.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2004年第11期685-687,共3页
Chinese Journal of Trauma
