尖吻蝮蛇血凝酶在乳腺癌手术创面的止血作用  

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

作　　者：陆旭[1] 杨鑫[1] 朱明炜[1] 华彬[1] 牛小娟[1] 肖文政[1] 韦军民[1] 

机构地区：[1]北京医院普外科,北京100730

出　　处：《中国医学科学院学报》2017年第2期183-187,共5页Acta Academiae Medicinae Sinicae

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。Objective To evaluate the hemostatic effect of hemocoagulase agkistrodon on surgical wound in breast cancer surgery. Methods Totally 6 0 patients undergoing breast cancer surgery were enrolled in this prospective, randomized, double-bl inded, and controlled study. All the patients met the inc lusion and ex-clusion criteria and signed the informed consent. Hemocoagulase agkistrodon （2 U） was inje cted 20 minutes be-fore surgery and 4 and 24 hours after surgery in the intervention group （= 30） , whereas normal saline was used instead in the control group （ n =30） . The volume of intraoperative b le ed in g , wound drainage volume 1 -3 days after surgery, and total drainage volume were recorded. Meanwhile, the change of blood coagulation funct ion, treatment safety, and cl inical outcomes were observed. Results The intra-operative hemorrhage volume o f 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 o f 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 hemo- agglutination 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 ef fect for patients undergoing breast cancer surgery without increasing the risk of thrombosis.

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 

分 类 号：R655.8[医药卫生—外科学]