注射用白眉蛇毒血凝酶致凝血功能障碍  

Blood coagulation disorders induced by hemocoagulase for injection

作　　者：黄卫 龙培培[2] Huang Wei;Long Peipei(Department of General Surgery, Bei′an Hospital of Chongqing, Chongqing 400020, China;Department of Science and Education, Chongqing Ninth People′s Hospital, Chongqing 400700, China)

机构地区：[1]重庆市北安医院普外科,400020 [2]重庆市第九人民医院科教部,400700

出　　处：《药物不良反应杂志》2018年第6期470-472,共3页Adverse Drug Reactions Journal

摘　　要：1例62岁女性患者在胆囊切除术后给予注射用白眉蛇毒血凝酶1KU入0.9%氯化钠注射液10ml静脉注射、3次/d。术前凝血功能检查未见异常。用药第3天,患者手术切口广泛渗血,凝血功能检查示凝血酶原时间(PT)18s,国际标准化比值(INR)1.5,活化部分凝血活酶时间(APTT)36s,凝血酶时间(TT)88s,纤维蛋白原(FIB)0.09g/L,D-二聚体3.6mg/L。考虑患者凝血功能障碍可能为注射用白眉蛇毒血凝酶所致,停用该药,给予氨甲苯酸注射液0.3g入0.9%氯化钠注射液100ml静脉滴注、1次/d,维生素K110mg肌内注射、2次/d。次日,患者手术切口未见明显渗血;5d后,患者PT14s,INR1.0,APTT29s,TT20s,FIB2.25g/L,D-二聚体0.5mg/L。A 62-year-old female patient received hemocoagulase for injection 1 KU,added into 10 ml of 0.9% sodium chloride injection in advance,by intravenous injection thrice daily after cholecystectomy.No abnormalities of preoperative blood coagulation test were found.On day 3 after the medication,the patient had extensive capillary hemorrhage from her surgical incision.The blood coagulation test showed prothrombin time(PT)18 s,international normalized ratio(INR)1.5,activated partial thromboplastin time(APTT)36 s,thrombin time(TT)88 s,fibrinogen(FIB)0.09 g/L,and D-dimer 3.6 mg/L.Considering that the blood coagulation disorders might be caused by hemocoagulase,it was stopped and aminomethylbenzoic acid injection 0.3 g,added into 100 ml of 0.9% sodium chloride injection in advance,was given by intravenous infusion once daily.In the meantime,vitamin K1 10 mg it was given by intramuscular injection twice daily.The next day,no significant capillary hemorrhage was found in the surgical incision.Five days later,the blood coagulation test showed PT 14 s,INR 1.0,APTT 29 s,TT 20 s,FIB 2.25 g/L,and D-dimer 0.5 mg/L.

关 键 词：凝血酶 血液凝固障碍 蛇毒液类 血凝酶 

分 类 号：R969.3[医药卫生—药理学]