经尿道膀胱肿瘤电切术后局部加用蛇毒血凝酶疗效观察  

Observation of curative effect of local addition of hemocoagulase after transurethral resection of bladder tumor

作　　者：陈文强 李俊[2] 杨丁源 王寓 邱明星 CHEN Wen-qiang;LI Jun;YANG Ding-yuan;WANG Yu;QIU Ming-xing(Clinical Medicine College, Southwest Medical University, Luzhou 646000, China;Department of Urology,Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital,Chengdu 610072,China;Chengdu Second People′s Hospital, Chengdu 610017, China)

机构地区：[1]西南医科大学临床医学院,四川泸州646000 [2]四川省医学科学院·四川省人民医院泌尿外科,四川成都610072 [3]成都市第二人民医院,四川成都610072

出　　处：《实用医院临床杂志》2022年第2期36-39,共4页Practical Journal of Clinical Medicine

摘　　要：目的观察经尿道膀胱肿瘤电切术(TURBT)后静脉应用尖吻蝮蛇血凝酶的基础上局部加用矛头蝮蛇血凝酶的止血效果。方法选取2019年6月至2020年12月于四川省人民医院接受TURBT治疗的123例膀胱癌患者,根据患者术后止血药物用药途径的不同,分为局部组45例,静脉组34例,联合组44例。对比三组术后凝血功能指标变化、尿液转清时间、带尿管时间、膀胱冲洗时间、术后24 h下腹部视觉模拟疼痛评分、膀胱痉挛症状评分、血红蛋白(Hb)下降值、并发症发生率。结果联合组带尿管时间、术后膀胱冲洗时间、术后24 h膀胱痉挛症状评分、术后Hb下降值均明显短于全身组和局部组(P<0.05),三组术后并发症发生率比较差异无统计学意义(P>0.05)。结论在TURBT术后,静脉使用尖吻蝮蛇血凝酶的同时局部使用矛头蝮蛇血凝酶能减少术后出血,缩短带尿管时间、术后膀胱冲洗时间,减轻下腹部疼痛感受,同时不会增加并发症的发生,具有较好的止血效果及安全性。Objective To observe the hemostatic effect of local application of hemocoagulase bothrops atrox on the basis of intravenous application of hemocoagulase agkistrodon after transurethral resection of bladder tumor(TURBT).Methods One hundred and twenty-three patients with bladder cancer treated with TURBT at Sichuan Provincial People′s Hospital from June 2019 to December 2020 were selected.The patients were divided into a local group(n=45),an intravenous group(n=34),and a combined group(n=44)according to the different routes of postoperative hemostatic drug administration.The changes of coagulation function indexes,time of urine clearing,time with urinary catheter,time of bladder irrigation,visual analog pain score of lower abdomen after 24 hours of operation,symptom score of bladder spasm,decrease value of hemoglobin(Hb),and incidence of complications were compared among the three groups.Results The time with urinary catheter,postoperative bladder irrigation time,postoperative bladder spasm symptom score after 24 hours of operation,and postoperative Hb drop value were significantly shorter or lower in the combined group than those in the intravenous and the local groups(P<0.05).The incidence of postoperative complications was not statistically different among the three groups(P>0.05).Conclusion After TURBT,intravenous use of hemocoagulase agkistrodon with local use of hemocoagulase bothrops atrox can reduce the postoperative bleeding,shorten the time of catheterization and postoperative bladder irrigation time,and relieve the pain in the lower abdomen.It does not increase the incidence of complications.Thus,it has better hemostatic effect and safety.

关 键 词：经尿道膀胱肿瘤电切术 蛇毒类血凝酶 术后出血 

分 类 号：R737.14[医药卫生—肿瘤]