尖吻蝮蛇血凝酶在泌尿外科手术中止血的疗效观察

目的：研究尖吻腹蛇血凝酶在泌尿外科手术中止血的价值。方法：将前列腺增生患者147例、膀胱肿瘤患者33例按照可比性的原则分为A、B、C3组进行研究，给予注射用尖吻蝮蛇血凝酶（1U／支），A组给予3支，B组给予2支，C组给于安慰剂，观察3组患者的止血效果与血凝指标。结果：在3组患者之间具有可比性的前提下，患者凝血酶原时间（胛）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原定量（FIB）以及D-二聚体（DD）方面比较，A组与B组患者之间的差异无统计学意义（P〉0．05）；但是A、B2组与C组之间的差异均具有统计学意义（P〈0．05）。A组和B组患者之间的止血时间、切口出血时间以及凝血异常比较，差异无统计学意义（P〉0．05）；但是A、B2组与c组之间的差异均具有统计学意义（P〈0．05）。结论：尖吻蝮蛇血凝酶在泌尿外科手术中具有较好的止血作用和安全性，疗效不随药物剂量增加而增加，一般情况下，使用2U即可达到良好的效果。

Hemostatic Efficacy of Haemocoagulase Agkistrodon in Patients Undergoing Urologic Surgery

OBJECTIVE：To evaluate the hemostatic efficacy of hemocoagulase agkistrodon in patients undergoing urologic surgery. METHODS： 147 patients with prostatic hyperplasia and 33 patients with bladder tumor were assigned to three groups according to comparability principle： group A （hemocoagulase agkistrodon 3 U ）, group B （hemocoagulase agkistrodon 2 U） and group C （placebo）. The hemostatic efficacy and blood clotting indexes in the three groups were recorded. RESULTS： In the presence of comparability, the differences between group A and group B in prothrombin time（ PT）, activated partial thromboplastin time （APTT）, thrombin time （TT）, fibrinogen quantitation （FIB） and D-dipolymer（DD） were not statistically significant（P 〉0.05） ; however, the differences between group A and C or between group B and group C in the above indexes were statistically significant（P 〈 0.05 ）. The differences between group A and group B in hemostatie time, incision bleeding time and disorders of hemostasis were not statistically significant（P 〉0.05） ; however, the differences in these indexes between group A and group C or between group B and group C were statistically significant （P 〈 0. 05）. CONCLUSION： Hemocoagulase agkistrodon showed satisfactory hemostatic efficacy and safety in urologic surgery. Its hemostatic effect is independent of drug dosage, and generally satisfactory efficacy can be achieved at a dose of 2U （ hemocoagulase agkistrodon）.