云南白药配合白眉蛇毒血凝酶治疗消化性溃疡出血的临床观察

目的：探讨云南白药配合白眉蛇毒血凝酶在治疗上消化道出血时的临床疗效。方法：选择中、轻度上消化道出患者82例,随机分为两组,治疗组40例用云南白药散剂与白眉蛇毒血凝酶联合用药,对照组42例单纯应用白眉蛇毒血凝酶治疗。结果：治疗组止血效果优于对照组,再出血率治疗组（2.511%）与对照组（9.523%）比较,也明显降低。结论：云南白药配合白眉蛇毒血凝酶治疗上消化道出血,止血效果明显,再出血率低。     

蛇毒血凝酶在全髋关节置换术中的局部应用

目的:研究局部应用蛇毒血凝酶减少全髋关节置换术失血量的有效性及安全性。方法:选择行单侧全髋关节置换术的患者45例,随机分为A、B、C组。A组不使用任何止血药物,B组在缝合关节囊后向关节腔内注射50 mL的氨甲环酸,C组在缝合关节囊后向关节腔内注射12 mL的蛇毒血凝酶注射液。统计、比较各组基本资料和血红蛋白、血小板、凝血常规及术中失血量、术后24 h引流量、输血率等指标,观察术后有无下肢深静脉血栓形成及肺部感染及切口感染等并发症。结果:3组术中失血量、术后深静脉血栓形成及肺部感染、切口感染等并发症发生率差异无统计学意义(P0.05)。术后24 h引流量3组分别为(396.7±139.5)mL、(303.3±91.5)mL、(206.7±106.7)mL,差异有统计学意义(P0.05),输血率3组分别为5/15、2/15、0,差异有统计学意义(P0.05);术后血红蛋白3组分别为(87.9±10.6)g/L,(96.9±10.7)g/L、(107.2±11.1)g/L,差异有统计学意义(P0.05);3组手术前后凝血常规、血小板变化差异无统计学意义(P0.05),均未出现血栓及肺部感染、切口感染等并发症。结论:局部应用蛇毒血凝酶注射液,能有效减少全髋关节置换术后失血量,降低输血率,并且不增加静脉血栓形成的风险。     

动态浊度法检查注射用血凝酶的细菌内毒素

目的：建立注射用血凝酶细菌内毒素检查法质量标准,并采用动态浊度法对其细菌内毒素检查进行方法学研究。方法：按《中国药典》2010年版二部,计算本品细菌内毒素限值。使用动态浊度法,研究注射用血凝酶对细菌内毒素检查试验的干扰情况,并定量测定样品中细菌内毒素含量。结果：标准曲线回归方程相关系数绝对值为0.9886,标准曲线成立。本品在0.25 KU·ml-1浓度时细菌内毒素回收率在50%~200%范围内,表明此浓度供试品对细菌内毒素检查法无干扰作用。结论：建立了本品细菌内毒素检查法质量标准,本品可采用动态浊度法进行细菌内毒素检查。     

探讨白眉蛇毒血凝酶治疗上消化道出血的疗效

目的：观察用白眉蛇毒血凝酶（邦亭）治疗上消化道出血的疗效。方法上消化道出血患者90例,随机分为治疗组和对照组,所有病例均给予扩容及调整水电解质紊乱,静滴奥美拉唑42.6 mg,每日1次;静滴卡络磺钠60 mg,每日1次,重度贫血者予输血。治疗组再应用邦亭4 KU加生理盐水20 mL口服,每日2次,对照组用去甲肾上腺素8 mg加生理盐水90 mL,每日分3次口服。结果治疗组总有效率93.75%,对照组总有效率80.95%,两组临床疗效差异有统计学意义（P〈0.05）结论：白眉蛇毒血凝酶是一种有效的、安全的治疗上消化道出血的药物,在临床止血治疗中值得推广应用。     

Hemocoagulase Injection blood anesthesia in joint operation

Objective:To investigate the role of Hemocoagulase Injection used in the joint operation and the effect on the blood coagulable function.Methods:A total of 60 patients who undergoing joint operation in our hospital were randomly divided into two groups.Experiment group(Group A,n=30)was injected with 2 U Hemocoagulase Injection in 5 min before anesthesia induction.The contrast group(Group B,n=30)was treated with 0.9%normal saline in 5 min before anesthesia induction.Then common anesthesia was given to the...     

急性超容血液稀释结合血凝酶用于全髋置换术节约用血的临床观察

目的观察急性血液稀释结合血凝酶用于全髋置换术节约用血的可行性和安全性。方法选择ASAⅠ～Ⅱ级择期全髋置换手术134例,随机分为Ⅰ组(不行急性超容液稀释)和Ⅱ组(行急性超容液稀释结合血凝酶),观察术中血压(BP)、心率(HR)、血小板计数(Platelet count,PLT)、凝血酶原时间(Prothrombin time PT)、部分凝血活酶时间(Actiaved partial thromboplastin time,APTT)、失血量和输血量。结果①两组失血量及输血量比较差异均有统计学意义(P<0.05)。②Ⅱ组BP在麻醉后、术中以及术后维持相对稳定,与Ⅰ组变化比明显,两组不同时间点BP比较差异均有统计学意义(P<0.05)。③两组血小板计数均下降,和术前比较差异均有统计学意义(P<0.05),两组间比较,差异均无统计学意义(P>0.05)。结论术前急性高容血液稀释结合立止血,可安全地应用于全髋关节置换术患者。     

尖吻蝮蛇血凝酶在成人腺样体肥大手术中的止血效果和安全性研究

【摘要】〓目的〓评价尖吻蝮蛇血凝酶(Haemoczxoagulase Agkistrodon,HCA, 商品名：苏灵)在成人腺样体肥大手术中的止血效果和安全性。 方法〓采取双盲和随机对照的方法,将手术患者50例随机分为实验组（A组）25例,术前半小时静注尖吻蝮蛇血凝酶2U;对照组（B组）25例,术前半小时静注生理盐水作为安慰剂模拟尖吻蝮蛇血凝酶。记录术中出血量、手术时间和血压波动范围等,并于术后第1d查凝血功能、血常规和肝功能等安全性指标进行观察。结果〓实验组止血有效率为76%,对照组止血有效率为21%,组间术中出血量的控制差异有统计学意义（P<005）;两组术前与术后血常规各指标变化比较差异均有统计学意义(P<005);两组术前与术后的ALT、TBIL、Bun、Cr及PT、TT、APTT、FIB的变化比较差异均无统计学意义（P>005)。结论〓尖吻蝮蛇血凝酶对成人腺样体肥大手术切口有较好的止血效果和安全性。     

The impact of hemocoagulase for improvement of coagulation and reduction of bleeding in fracture-related hip hemiarthroplasty geriatric patients: A prospective,single-blinded,randomized, controlled study

BackgroundUncontrolled bleeding is associated with poor outcomes and mortality in geriatric patients undergoing hemiarthroplasty. Hemocoagulase agkistrodon is a hemocoagulative, anti-hemorrhagic enzyme complex from Deinagkistrodon acutus snake venom. This study aimed to investigate the efficacy of hemocoagulase agkistrodon on coagulation and bleeding outcomes in fracture-related hemiarthroplasty.Patients and methodsThis was a prospective, single-blinded, randomized controlled trial carried out between October 2013 and September 2014 in 96 geriatric patients undergoing hemiarthroplasty for unilateral femoral neck fracture. Patients were administrated hemocoagulase agkistrodon (n = 48) or normal saline (n = 48). Intraoperative blood loss, transfusion volume and rate, and drainage were assessed. Hemoglobin (Hb) and coagulation parameters (prothrombin time [PT], thrombin time [TT], plasma fibrinogen [FIB], and activated partial thromboplastin time [aPTT]) were recorded preoperatively and 30 min and 1, 3, and 5 days after surgery. Complications were followed up for 4 weeks.ResultsCompared to controls, hemocoagulase patients exhibited lower intraoperative blood loss (P < 0.01) and postoperative blood loss, total drainage, mean transfusion volume, and transfusion rates (all P < 0.05), with lower aPTT at 30 min (P < 0.05). No significant differences in postoperative FIB were observed. Controls exhibited significantly higher PP and TT on day 1, and Hb on days 1, 3, and 5 (P < 0.05). No serious complications were reported.ConclusionsHemocoagulase reduced blood loss and transfusion in fracture-related hip hemiarthroplasty without increasing short-term adverse event rates. In geriatric populations, hemocoagulase could be used for limiting bleeding and related complications.Trial registration: This trial is registered in the Chinese Clinical Trial Register (no. ChiCTR-TRC-14004379)     

蛇毒血凝酶治疗异基因造血干细胞移植后重度出血性膀胱炎效果观察

目的：探讨蛇毒血凝酶治疗异基因造血干细胞移植（HSCT）后重度出血性膀胱炎（HC）的临床效果。方法20例接受异基因HSCT的患者在移植后14～70 d发生重度HC,接受蛇毒血凝酶（静脉滴注1 U／次,1次／12 h,×5 d）治疗。蛇毒血凝酶治疗前、后分别留取尿液标本,通过肉眼观察和显微镜检查评定疗效。结果20例重度HC患者接受蛇毒血凝酶治疗后,18例达到治愈,肉眼血尿消失中位时间为应用蛇毒血凝酶后28 d（4～127 d）,1例有效,1例无效。20例患者均未出现严重并发症。结论蛇毒血凝酶治疗HSCT后重度HC安全、有效。     

奥美拉唑血凝酶去甲肾上腺素联合治疗新生儿出血症的疗效分析

目的:探讨奥美拉唑、血凝酶、去甲肾上腺素联合治疗新生儿出血症的疗效。方法:对照组应用常规禁食、输血、留置胃管等治疗方法,治疗组在对照组的基础上加用奥美拉唑、血凝酶和去甲肾上腺素进行联合治疗。结果:治疗组总有效率明显比对照组高,两组有显著性差异(P0.05),具有统计学意义。结论:奥美拉唑、血凝酶、去甲肾上腺素联合治疗新生儿出血症过程中,联合用药具有协同作用,值得临床推广应用。