根治性肾癌切除术围手术期应用巴曲亭对凝血功能的影响  

Effect of hemocoagulase on hemoagglutination in perioperative period of radical nephrectomy for renal carcinoma

作　　者：张治国[1] 欧阳骏[1] 丁翔[1] 龙建华[1] 

机构地区：[1]苏州大学第一附属医院,江苏苏州215006

出　　处：《现代中西医结合杂志》2010年第24期3017-3018,3030,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨根治性肾癌切除术围手术期应用巴曲亭对凝血功能的影响。方法 60例根治性肾癌切除术患者随机分为A、B、C 3组各20例,分别于切皮前5 min及术后静脉注射巴曲亭2 kIU、止血敏2.0 g及立止血2 kIU,每日1次,持续3 d。3组均给药前及术毕抽取静脉血,检测血浆凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原含量(Fbg)及血常规,记录术中出血量和术后引流量。结果 B组术毕Hb、RBC、Plt、Hct水平较给药前均显著下降,PT、APTT均明显延长,Fbg变化不明显。A、C组术毕Fbg较给药前均显著下降,其他指标变化不大。A、C组术毕Hb、RBC、Plt、Hct水平较B组均显著升高,Fbg较B组均显著下降,出血量及术后引流量较B组均显著减少。A、C组各指标比较均无显著性差异。结论根治性肾癌切除术围手术期应用巴曲亭可减少术中术后渗血,而对凝血功能影响小,是高效、安全的。Objective It is to approach the influence of hemocoagulase on hemoagglutination in perioperative period of radical nephrectomy for renal carcinoma.Methods Sixty patients with renal carcinoma undergoned radical nephrectomy were randomly divided into 3 groups with 20 patients in each group.The patients were received intravenous injection of Hemocoagulase 2 kIU in group A,dicynone 2.0 g in group D and Reptilase 2 kIU in group C at five minutes before operation and after preation once a day,continuing for three days.Venous blood was drawn-off to observe the change of plasma prothrombin time（PT）,partial thromboplastin time（APTT）,fibrinogen（Fbg） and blood routine examination before administration and after operation respectively and record the volume of blood loss and postoperative drainage.Results In group B,the levels of Hb,RBC,Plt and Hct were all decreased significantly after operation,the value of PT and APTT were both extended,but the value of Fbg did not change significantly.The value of Fbg were both decreased significantly in group A and C,the change of the else was not obvious.The levels of Hb,RBC,Plt and Hct in group A and C were all increased obviously than that in group B,there was no significant difference between group A and group C.The values of Fbg in group A and C were both decreased obviously than in group B.The volume of blood drainage after operation in groups A and C were both less than in group B.However,there was no significant difference between group A and C.Conclusion The application of hemocoagulase in perioperative period can reduce capillary hemorrhage and will not give an impact to hemoagglutination significantly,it is effective and safe.

关 键 词：巴曲亭 根治性肾癌切除术 凝血功能 

分 类 号：R737.11[医药卫生—肿瘤]