中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2017, Vol. 39 ›› Issue (2): 183-187.doi: 10.3881/j.issn.1000-503X.2017.02.004

• 论著 • 上一篇    下一篇

尖吻蝮蛇血凝酶在乳腺癌手术创面的止血作用

陆旭, 杨鑫, 朱明炜(), 华彬, 牛小娟, 肖文政, 韦军民   

  1. 北京医院普外科,北京 100730
  • 收稿日期:2016-10-17 出版日期:2017-04-20 发布日期:2017-04-20
  • 作者简介:

    通信作者:朱明炜 电话:010-85137703,电子邮件:zhumw2013@163.com

Hemostatic Effect of Hemocoagulase Agkistrodon on Surgical Wound in Breast Cancer Surgery

Xu LU, Xin YANG, Mingwei ZHU(), Bin HUA, Xiaojuan NIU, Wenzheng XIAO, Junmin WEI   

  1. Department of General Surgery,Beijing Hospital,Beijing 100730,China
  • Received:2016-10-17 Online:2017-04-20 Published:2017-04-20

摘要:

目的 评价尖吻蝮蛇血凝酶对乳腺癌手术患者的止血作用及安全性。方法 采用前瞻、随机、盲法、对照的研究设计,共纳入符合入排标准并获得知情同意的乳腺癌患者60例,随机分为研究组和对照组,每组各30例;研究组于术前20 min静脉注射尖吻蝮蛇血凝酶2 U,术后4和24 h再次注射2 U,对照组对应时间给予生理盐水;观察记录术中出血量、术后1~3 d创面引流量及创面总引流量;同时观察凝血功能变化和安全性,以及临床结局指标。结果 研究组术中出血量 (95.0±48.3) g较对照组 (144.8±105.4) g显著减少(t=-2.07,P=0.044);研究组术后创面总引流量(166.7±71.2)g显著少于对照组(251.4±166.3) g(t=-2.29,P=0.029);凝血功能指标两组比较差异无统计学意义。两组患者未出现血栓等并发症;住院时间两组比较差异无统计学意义[(15.92±2.32)d比(15.00±3.53)d,t=-1.057,P=0.297]。未出现研究药物相关的不良事件。结论 尖吻蝮蛇血凝酶对乳腺癌手术创面的止血作用较好,未增加血栓形成的风险,有较好的安全性。

关键词: 尖吻蝮蛇血凝酶, 乳腺癌手术, 凝血功能, 安全性, 静脉血栓, 随机对照研究

Abstract:

Objective To evaluate the hemostatic effect of hemocoagulase agkistrodon on surgical wound in breast cancer surgery. Methods Totally 60 patients undergoing breast cancer surgery were enrolled in this prospective,randomized,double-blinded,and controlled study. All the patients met the inclusion and exclusion criteria and signed the informed consent. Hemocoagulase agkistrodon (2 U) was injected 20 minutes before surgery and 4 and 24 hours after surgery in the intervention group (n=30),whereas normal saline was used instead in the control group (n=30). The volume of intraoperative bleeding,wound drainage volume 1-3 days after surgery,and total drainage volume were recorded. Meanwhile,the change of blood coagulation function,treatment safety,and clinical outcomes were observed. Results The intra-operative hemorrhage volume of the intervention group [(95.0±48.3)g] was significantly lower than that of the control group [(144.8±105.4)g] (t=-2.07,P=0.044). The volume of total drainage of the intervention group [(166.7±71.2)g] was significantly lower than that of the control group [(251.4±166.3)g] (t=-2.29,P=0.029). The hemoagglutination indicators were similar in the two groups and no complication such as thrombosis occurred. The length of hospital stay of the intervention group [(15.00±3.53)d] was similar to that of the control group [(15.92±2.32)d] (t=-1.057,P=0.297). No research drug-related adverse event was occurred in our study. Conclusion Hemocoagulase agkistrodon has good hemostatic effect for patients undergoing breast cancer surgery without increasing the risk of thrombosis.

Key words: hemocoagulase agkistrodon, breast cancer operation, hemoagglutination, safety, venous thrombus, randomized controlled trial

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