蛇毒凝血酶对前列腺增生患者术中凝血及纤溶功能的影响

Effect of Snake Venom Thrombin onCoagulation and Fibrinolysis in Patients with Benign Prostatic Hyperplasia

目的探讨蛇毒凝血酶对前列腺增生患者术中凝血及纤溶功能的影响。方法将在我院行耻骨上前列腺切除术的86名患者随机分为两组,观察组术前30min及术后给予蛇毒凝血酶静滴,对照组按常规处理,不给予止血药,记录患者手术时间及术中术后出血量,并于术前2h、术中、术后2h测定两组患者aPTT、PT、TT、纤维蛋白原的数值及D二聚体的水平。结果两组手术时间无明显差异,观察组术中及术后出血均明显少于对照组(P<0.05),观察组术中和术后aPTT值较术前缩短,术中和术后纤维蛋白原的水平较术前降低,差异具有统计学意义(P<0.05),PT和TT值无明显缩短,D-二聚体水平无明显升高,对照组5项生化指标均无明显变化(P>0.05)结论蛇毒凝血酶能明显减少患者出血量,促进凝血,对纤溶功能无影响,不增加血栓形成的风险。

Objective Objective to investigate the effect of snake venom thrombin on coagulation and fibrinolysis in patients with benign prostatic hyperplasia.Methods 86 patient receiving Suprapubic prostatectomy were randomly divided into two groups.The test group were given nake venom thrombin-like enzyme before and after prostatectomy while the control group were not given any kind of hemostatic.The time of operation and the amount of bleeding during and postoperative were recorded.Before、during、after the surgery,the level of aPTT、PT、TT、Fbg and D-dimer were monitored.Results There was no statistical difference on operation time between two groups.The amount of bleeding during and after operative of the test group was significantly reduced.After given snake venom thrombin-like enzyme,the values of aPTT and fibrinogen were significantly reduced(P<0.05)while the difference of PT、TT、D-dimer didn’t have statistical significance(P>0.05).There were no significant changes in these five biochemical indexes of the control group(P>0.05).Conclusion Snake venom thrombin-like enzyme can reduce the amount of bleeding during and after operative.It promotes coagulation process and do not increase the risk of thrombosis.