尖吻腹蛇血凝酶在鼻中隔偏曲矫正术中止血疗效及安全性观察

摘要

目的：通过对尖吻腹蛇血凝酶在鼻中隔偏曲矫正术围手术期的应用，评估尖吻腹蛇血凝酶在鼻腔手术中的止血疗效及其安全性。方法利用前瞻性对照研究方法，选择于2012年6月—2013年6在该院行鼻中隔偏曲矫正手术治疗的62例患者作为研究对象，按入院前后顺序随机分为实验组和对照组，对于入选患者行一般资料的统计学比较，两组患者的资料具有均一性，可进行进一步的比较研究。一组在术前给2u尖吻腹蛇血凝酶（实验组），另一组不用尖吻腹蛇血凝酶（对照组），比较手术过程中两组患者出血量，评价尖吻腹蛇血凝酶对减少术中出血量的影响，比较应用HCA患者术前、术后3 d血常规、凝血常规，评价应用HCA对血常规、凝血的影响。结果实验组术中出血量明显较对照组减少，差异有统计学意义（χ2=7.180，P=0.00）。实验组与对照组血常规、凝血功能比较，差异无统计学意义（χ2血常规=0.866，P 血常规=0.478；χ2凝血=0.285，P凝血=0.803）。实验组术前、术后3 d 的凝血功能、血常规结果比较，差异无统计学意义（PPT=0.098、PTT=0.685、Pp=0.796、PFIB=0.744；PRBC=0.275、PHGB=0.12、PPLT=0.393）。结论尖吻腹蛇血凝酶对减少术中出血量有明显疗效，但对患者血常规、凝血功能无明显影响。%Objective To evaluate the hemostatic efficacy and safety of HCA used in nasal operation by studying the application of HCA to nasal septum deviation diorthosis during the perioperative period. Methods A prospective comparison study method was used. 62 patients underwent nasal septum deviation diorthosis in the hospital from June 2012 to Tune 2013 were selected as the subjects and randomly divided into experimentol group and contral group in accordance with the order of admission. A statistical comparison was conducted on the two groups because the data of them had the uniformity for further comparative study. One group was given 2u HCA before surgery (the experimental group), the other group was not (the control group). The amount of bleeding of the two groups during operation was compared and the effect of HCA on reducing the intraoperative blood loss was evaluated. And the routine blood test and routine blood coagulation test before and 3 days after the surgery in the patients using HCA were com-pared, and the effect of HCA on routine blood test and routine blood clotting was assessed. Results The intraoperative blood loss of the experimental group was much less than that of the control group, the difference was statistically significant (χ2=7.180, P=0.00). The differences in the routine blood test and blood clotting function between the two groups had no statistical significance (χ2blo d=0.866,Pblo d=0.478; χ2clot ing=0.285, Pclot ing=0.803). There were no statistically significant differences in the blood clotting function and routine blood test before and 3 days after the surgery in the experimental group(PPT=0.098, PTT=0.685, PApTT=0.796, PFIB=0.744, PRBC=0.275, PHGB=0.12, PPLT=0.393). Conclusion HCA has significant effect on reducing the intraoperative blood loss, but no obvious im-pact on routine blood test and blood coagulation function.