發(fā)布時(shí)間：2018-11-26 21:29

【摘要】：目的評(píng)價(jià)尖吻蝮蛇血凝酶對(duì)乳腺癌手術(shù)患者的止血作用及安全性。方法采用前瞻、隨機(jī)、盲法、對(duì)照的研究設(shè)計(jì),共納入符合入排標(biāo)準(zhǔn)并獲得知情同意的乳腺癌患者60例,隨機(jī)分為研究組和對(duì)照組,每組各30例;研究組于術(shù)前20 min靜脈注射尖吻蝮蛇血凝酶2 U,術(shù)后4和24 h再次注射2 U,對(duì)照組對(duì)應(yīng)時(shí)間給予生理鹽水;觀察記錄術(shù)中出血量、術(shù)后1~3 d創(chuàng)面引流量及創(chuàng)面總引流量;同時(shí)觀察凝血功能變化和安全性,以及臨床結(jié)局指標(biāo)。結(jié)果研究組術(shù)中出血量(95.0±48.3)g較對(duì)照組(144.8±105.4)g顯著減少(t=-2.07,P=0.044);研究組術(shù)后創(chuàng)面總引流量(166.7±71.2)g顯著少于對(duì)照組(251.4±166.3)g(t=-2.29,P=0.029);凝血功能指標(biāo)兩組比較差異無統(tǒng)計(jì)學(xué)意義。兩組患者未出現(xiàn)血栓等并發(fā)癥;住院時(shí)間兩組比較差異無統(tǒng)計(jì)學(xué)意義[(15.92±2.32)d比(15.00±3.53)d,t=-1.057,P=0.297]。未出現(xiàn)研究藥物相關(guān)的不良事件。結(jié)論尖吻蝮蛇血凝酶對(duì)乳腺癌手術(shù)創(chuàng)面的止血作用較好,未增加血栓形成的風(fēng)險(xiǎn),有較好的安全性。
[Abstract]:Objective to evaluate the hemostatic effect and safety of Agkistrodon acutus hemagglutinin on breast cancer patients. Methods A total of 60 breast cancer patients who met the admission criteria and obtained informed consent were enrolled in a prospective, randomized, blind and controlled study design. They were randomly divided into study group and control group with 30 cases in each group. In the study group, blood coagulase 2U was injected intravenously 20 min before operation, and 2 U was injected again at 4 and 24 hours after operation. The control group was given normal saline at the corresponding time, and the amount of intraoperative bleeding was recorded, and the wound drainage volume and total wound drainage flow were observed 1 and 3 days after operation. At the same time, the changes of coagulation function and safety, as well as the clinical outcome index were observed. Results the intraoperative bleeding volume in the study group (95.0 鹵48.3) g was significantly lower than that in the control group (144.8 鹵105.4) g (t = 2.07 鹵0.044). The total wound drainage volume (166.7 鹵71.2g) in the study group was significantly lower than that in the control group (251.4 鹵166.3) g (/ t), and there was no significant difference in coagulation function between the two groups. There were no complications such as thrombus in the two groups, and there was no significant difference in hospitalization time between the two groups [(15.92 鹵2.32) d vs (15.00 鹵3.53) d ~ (-1. 57) P ~ (-1) 0.297]. There were no adverse events related to the study of drugs. Conclusion the hemostatic effect of Agkistrodon acutus hemagglutinin on the wound of breast cancer surgery is better, but the risk of thrombosis is not increased.
【作者單位】： 北京醫(yī)院普外科;
【分類號(hào)】：R737.9

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