注射用血凝酶对食管癌及结肠癌手术患者凝血功能影响.docVIP

注射用血凝酶对食管癌及结肠癌手术患者凝血功能影响 　【摘要】 目的 研究注射用血凝酶（巴曲亭）对食管癌及结肠癌手术患者凝血功能的影响。方法 选取食管癌及结肠癌患者各40例，随机分为巴曲亭组和对照组各20例。巴曲亭组：术前30min肌肉注射巴曲亭1u，切皮后15min静脉注射巴曲亭2u。对照组：等剂量生理盐水术前30min肌肉注射，切皮后15min静脉注射。测定术前（24h）和术中（3h）凝血功能［PT、APTT、PT(INR)、FIB、D-D］及血常规（Hb、RBC、PLT）。并记录输血量、输液量、尿量。同时观察有无不良反应发生。结果 两组患者对比凝血功能差异无显著性（Pgt;0.05）。巴曲亭组未出现不良反应。结论 巴曲亭作为止血药不影响食管癌及结肠癌手术患者的凝血功能，在术中使用是安全的。 【关键词】 血凝酶；食管癌；结肠癌；凝血功能 【Abstract】 Objective To investigate the influence of hemocoagulase injection on blood coagulation function during the operation on carcinoma of esophagus and carcinoma of colon.Methods Forty patients of carcinoma of esophagus and forty patients of carcinoma of colon were randomly divided into two groups：hemocoagulase group and control group. Patients in hemocoagulase group received hemocoagulase 1u im 30min before operation and 2u iv 15min after operation. Patients in control group has the same dose of normal saline solution. We determined the blood coagulation function of PT、 APTT、PT(INR)、FIB、Ｄ-D level and the hematologic variables of Hb、RBC、PLT at the time of 24h before operation and 3h after the operation. We observed the blood transfusion volume、urine volume and the adverse reaction.Results There was no significant difference in blood coagulation function between two groups (Pgt;0.05). Hemocoagulase group does not increase the adverse reaction.Conclusion Hemocoagulase is an effctive and safe hemostatic drug in patients during he operation on carcinoma of esophagus and carcinoma of colon. 【Key words】 hemocoagulase；carcinoma of esophagus； carcinoma of colon； blood coagulation function 注射用血凝酶（巴曲亭）是从巴西矛头蝮蛇蛇毒中提取的酶性止血剂，可用于各种出血疾病或出血状态，特别是毛细血管出血，可缩短患者的出血时间，减少出血量，保护凝血功能［1］。本文研究注射用血凝酶对食管癌及结肠癌手术患者凝血功能的影响。 1 资料与方法 1.1 一般资料 选取本院择期行食管癌及结肠癌手术患者各40例，随即分为巴曲亭组和对照组各20例。年龄18～70岁，性别不限；ASAⅠ～Ⅱ级；术前肝肾功能正常；无血液系统疾病，术前未应用其他凝血或止血药物；血小板计数在75×109/L以上。 1.2 用药方法 患者入室后建立静脉通路，巴曲亭组：术前30min肌肉注射巴曲亭1u，切皮后15min静脉注射巴曲亭2u。对照组：等剂量生理盐水术前30min肌肉注射，切皮后15min静脉注射。两组患者麻醉诱导和麻醉维持方法相同。 1.3 观察指标 术前（24h）和术中（3h）检测血浆凝血酶原 时间（