尖吻蝮蛇血凝酶在耳鼻喉手术后应用的安全性评价

目的评价耳鼻喉手术后使用尖吻蝮蛇血凝酶止血的安全性。方法选取武装警察部队总医院2010年9—11月耳鼻喉科手术患者30例，术前及术中不予止血药，术后根据创面情况给予尖吻蝮蛇血凝酶静脉注射1—2U／次，1次／d，疗程1-3d（使用前用1ml注射用水溶解）。采用自身对照的研究方法，观察术前和术后第3天患者的凝血功能、血常规、肝肾功能、心电图等指标变化。结果30例患者术前WBC（6．6±1．7）×10^9／L、RBC（4．6±0．6）×10^12／L、Hb（142±18）异／L、PLT（219±44）X10^9／L、ST（10．9±0．7）s、TT（17．1±0．9）s、Am（27±3）s、FIB（2534±540）mg／L、ALT（26±17）U／L、TBll（13±7）μmol／L、BUN（5．2±1．5）mmol／L、cr（69±17）μmol／L；术后第3天wBC（7．8±3．0）×10^9／L、RBC（4．4±0．5）X10^12／L、Hb（133±16）g／L、PLT（212±32）X10^9／L、Prr（11．0±0．6）S、TT（16．0±1．9）s、APrT（26±3）S、FIB（2973±754）mg／L、ALT（22±12）U／L、TBIl（13±8）μmol／L、BUN（5．1±1．8）mmol／L、Cr（70±19）μmol／L。给药后与术前比较差异均无统计学意义（均P〉0．05）。用药期间心电图未见特殊异常变化、无不良事件。结论耳鼻喉手术后使用尖吻蝮蛇血凝酶减少创面渗血有较高的安全性。

Safety research of haemocoagulase agkistrodon application after otolaryngological operation

Objective To evaluate the safety of hemocoagulase agkistrodon application after the otolaryngo- logical operation. Methods Totally 30 patients with otolaryngology surgery in the Chinese People＇s Armed Police General Hospital from September 2010 to November 2010 were selected. They were not given hemostatie before oper- ation and during operation. They were given haemocoagulase agkistrodon after operation according the bleeding situa- tion, 1-2 U one time for 1-3 days （dissolve 1 ml water for injection before using）. The self-comparative method was used to observe the coagulation function, blood routine examination, liver and kidney function and ECG changes be- fore operation and after surgery in 3 days. Results Two groups showed no significant differences in the coagulation parameters and safety indexes （ all P 〉 0.05）. There were no adverse events occurring. Conclusion The applica- tion of haemocoagulase agkistrodon after otolaryngological operation is safe.