注射用尖吻蝮蛇血凝酶在肝切除手术中止血效果及安全性的比较

目的 比较注射用尖吻蝮蛇血凝酶与其他止血药物在肝切除术中的止血效果,并观察临床安全性.方法 将2014年11月至2016年2月该院肝胆外科行肝切除术的122例患者按照术前纳入及排除标准分为注射用尖吻蝮蛇血凝酶(A组)、注射用矛头蝮蛇血凝酶(B组)及醋酸去氨加压素注射液组(C组),按照临床研究方案给药后对3组患者疗效性指标(切口创面止血时间、切口创面出血量、术后24 h引流量)和手术前、后安全性指标(血常规、凝血功能、肝肾功能)进行比较.结果 3组患者的切口创面止血时间、切口创面出血量、术后24 h引流量差异无统计学意义(P＞0.05);各组患者血常规、凝血功能、肝肾功能指标给药前和给药后第3天组间及组内比较,差异无统计学意义(P＞0.05);出院时心电图、双下肢B超检查均未见异常;本次临床研究中各组病例无不良事件发生.结论 注射用尖吻蝮蛇血凝酶在肝切除术中的止血效果与其他止血药相似,对手术后血常规、凝血功能、肝肾功能指标无影响,具有较好的疗效性及安全性,值得在肝切除术中使用.

Comparison of hemostatic effect and safety of injection of Agkistrodon acutus venom coagulation in liver resection

Objective To compared hemostatic effect of agkistrodon haemocoagulase and other hemostatic agents in hepatectomy,and observe clinical safety.Methods From November 2014 to February 2016,122 patients undergoing hepatectomy of the department of hepatobiliary surgery in the hospital,according to the inclusion and exclusion criteria,were randomly divided into three groups,which was group A-haemocoagulase agkistrodon for injection,group B-ferdelance haemocoagulase for injection and group Cdesmopressin acetate injection.After drug administration,according to the clinical research plan,the indexes for therapeutic effectsbleeding time of wound,bleeding volume of wound,postoperative drainage volume for 24 h,preoperative and postoperative safety indices-Routine blood test,clotting function,liver and kidney function were compared among the three groups.Results The general data of the 3 groups were comparable.The bleeding time of wound,bleeding volume of wound,postoperative drainage volume for 24 h showed no significant difference(P＞0.05).Routine blood test,coagulation function,liver and kidney function,pre-admi nistration and post-administration administration of the group on the third day between and within groups were compared and showed no significant difference(P＞0.05).ECG and lower extremity ultrasound examination showed no abnormality in each group.No adverse events happened in the cases of groups for the clinical study.Conclusion Hemostatic effects of haemocoagulase agkistrodon for injection and other hemostatic drugs were similar in hepatectomy.No sinificant adverse effects on postoperative routine blood,coagulation function,liver and kidney function,with good efficacy and safety,being worthy of using widely worth in hepatectomy.