机构地区:[1]沧州市人民医院泌尿外科,河北沧州061001
出 处:《临床药物治疗杂志》2022年第11期22-26,共5页Clinical Medication Journal
基 金:河北省卫生厅科研计划项目(20200172);沧州市科技计划项目(183302132)。
摘 要:目的探讨局部肌内注射白眉蛇毒血凝酶对微拉激光治疗巨大前列腺增生患者出血及凝血功能的影响。方法纳入2019年10月至2021年10月沧州市人民医院收治的巨大前列腺增生患者,根据治疗方法的不同将其分为观察组和对照组。两组患者均实施微拉激光手术治疗,对照组术前1晚22:00、术前1 h、术后6 h和18 h分别肌内注射1 mL 0.9%氯化钠注射液。观察组在相同的时间肌内注射1单位的白眉蛇毒血凝酶(溶于1 mL 0.9%氯化钠注射液)。记录两组患者术后相关指标及术中出血量、术后出血量,对比两组术前24 h、术后72 h凝血功能及纤溶功能。结果两组各41例患者,观察组手术时间、膀胱冲洗时间、留置导尿管时间及术后血红蛋白降低值、术中出血量、术后出血量均低于对照组[(76.28±7.27)min比(85.98±7.19)min、(0.91±0.12)d比(1.56±0.14)d、(2.78±0.32)d比(3.48±0.42)d、(1.09±0.21)g/L比(1.67±0.24)g/L、(301.06±19.23)mL比(903.98±18.29)mL和(304.09±19.14)mL比(804.29±17.23)mL],差异均有统计学意义(均P<0.05)。观察组与对照组患者膀胱顺应性(BC)、最大尿流率(Qmax)及国际前列腺症状评分(IPSS)比较[(29.27±2.43)mL/cm H2O比(29.06±2.39)mL/cm H2O、(16.02±2.09)mL/s比(16.78±2.16)mL/s、(3.81±1.01)分比(4.03±1.03)分],差异均无统计学意义(均P>0.05)。术前24 h,观察组与对照组患者血浆纤维蛋白原(Fib)、D-二聚体(D-D)、部分活化凝血酶时间(APTT)、血浆凝血酶原时间(PT)比较,差异无统计学意义(P>0.05),术后72 h,两组患者Fib、D-D、APTT、PT比较[(12.98±4.08)g/L比(12.60±3.97)g/L、(71.34±18.41)μg/L比(71.83±18.83)μg/L、(3.92±1.03)s比(3.97±1.07)s、(37.87±10.76)s比(38.67±10.69)s],差异均有统计学意义(均P<0.05)。术前24 h,两组患者纤溶酶原激活抑制物(PAI-1)及组织型纤溶酶原激活物(t-PA),差异均无统计学意义(均P>0.05),但术后72 h观察组与对照组比较[(12.54±2.81)ng/mL比(12.48±2.93)ng/mObjective To investigate the effect of local intramuscular injection of hemocoagulase from the venomous eye⁃brow snake on bleeding and coagulation function in patients with giant prostatic hyperplasia treated by micro-pull laser.Methods Patients with giant prostatic hyperplasia admitted to Cangzhou People's Hospital from October 2019 to October 2021 were enrolled and divided into observation group and control group according to different treatment methods.The patients in both groups were treated with micro-pull laser surgery.The control group received intramuscular injection of 1 mL 0.9%sodium chloride injection at 22:00 one night before surgery,1 hour before surgery,6 hours after surgery,18 hours after surgery,respectively;while the observation group received intramuscular injection of 1 unit of hemocoagulase(dissolved in 1 mL 0.9%sodium chloride injection)at the same time.The postoperative related indexes,intraoperative blood loss and postopera⁃tive blood loss of the two groups were recorded,and the coagulation function and fibrinolytic function of the two groups were compared 24 hours before operation and 72 hours after operation.Results There were 41 cases in each group.The operation time,bladder flushing time,indwelling catheter time,postoperative hemoglobin reduction value,intraoperative blood loss and postoperative blood loss in the observation group were lower than those in the control group[(76.28±7.27)min vs(85.98±7.19)min,(0.91±0.12)d vs(1.56±0.14)d,(2.78±0.32)d vs(3.48±0.42)d,(1.09±0.21)g/L vs(1.67±0.24)g/L,(301.06±19.23)mL vs(903.98±18.29)mL,(304.09±19.14)mL vs(804.29±17.23)mL],and the differences were significant.There were no significant differences in bladder compliance(BC),maximum urinary flow rate(Q_(max))and international prostate symptom score(IPSS)between the observation group and the control group[(29.27±2.43)mL/cm H_(2)O vs(29.06±2.39)mL/cm H_(2)O,(16.02±2.09)mL/s vs(16.78±2.16)mL/s,(3.81±1.01)scores vs(4.03±1.03)scores](P>0.05).24 h before surgery,there were no signif
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