尖吻蝮蛇血凝酶在全膝关节置换术中的应用  

Application of Agkistrodon Hemocoagulase in Total Knee Arthroplasty

作　　者：张广防[1] 曾朝坤[1] 洪庆雄[1] 吴文庆[1] 

机构地区：[1]广东省中医院,广东广州510375

出　　处：《中外医学研究》2012年第22期16-17,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的：观察尖吻蝮蛇血凝酶在全膝关节置换术中的止血作用及对凝血功能的影响及其安全性.方法：54 例美国麻醉医师协会（ASA） 评分Ⅰ～ Ⅱ级择期全膝关节置换术患者随机分为两组,每组27 例,A 组（ 血凝酶组）：松止血带前15 min 静脉注射尖吻蝮蛇血凝酶2 kU ;B 组（ 对照组）：仅给予等量生理盐水静脉注射.测定术中及术后总出血量,并于术前、术毕、术后第1 天检测相关凝血功能指标,观察患者术后是否出现下肢深静脉栓塞的临床症状,并于术后7 d 进行下肢血管多普勒超声检查.结果：A 组患者出血量明显少于B 组患者（P〈0.05）.两组凝血功能指标差异均无统计学意义（P〉0.05）.术后7 d 未发现下肢深静脉血栓形成.结论：术中使用尖吻蝮蛇血凝酶对全膝关节置换术具有较好的止血效果和安全性,不会增加术后下肢深静脉血栓形成的风险.Objective ：To evaluate the effects of agkistrodon hemocoagulase on its hemostatic and hemoagglutinant function and safety on the patients with total knee arthroplasty（TKA）.Methods ：Fifty-four ASA I - II patients undergoing TKA were randomly and equally divided into two groups.Group A （hemocoagulase group） were received hemocoagulase for 2 kU 15 min before tourniquet deflation.Group B （control group） were received equal volume of saline.The total hemorrhagic volume, blood coagulation and deep vein thrombosis were measured and compared between the two groups.Results ：The total perioperative blood loss in Group A was significantly less than that in Group B （P〈0.05）.Blood coagulation results were similar between the two groups（P〉0.05）.No deep vein thrombosis was reported. Conclusion ：Perioperative blood loss can be reduced by using hemocoagulase that can attain a transient improvement in perioperative blood coagulation function and then can recover to norm postoperatively, as indicating that usage of hemocoagulase can not result in postoperative deep vein thrombosis.

关 键 词：尖吻蝮蛇血凝酶 全膝关节置换术 凝血功能 

分 类 号：R687.4[医药卫生—骨科学]