血凝酶不同给药方法用于脊柱手术止血的效果

Hemostatic effect of hemocoagulase with different administration method in spinal operation

目的 :观察血凝酶在脊柱外科手术中局部和静脉 2种给药方法的止血效果。方法 :椎管减压、腰椎间盘摘除术病人 90例 ,随机分为 3组 ,每组 30例 ,3组病人手术指征及麻醉方法选择相同。合用组术前 15min血凝酶 1单位静脉注射 (静注 )、术中2单位稀释后在出血部位局部喷洒 ;静脉组术前 15min血凝酶 1单位静注 ,术中 2单位静脉滴注 ;对照组不应用任何止血药物。观察 3组病人术中出血量、浓缩红细胞输入量和生命体征。结果 :同对照组比较 ,合用组和静脉组术中出血量、浓缩红细胞输入量均明显减少 (P <0 .0 1) ,合用组又少于静脉组 ,(6 89±s 15 0 )mLvs (80 3± 186 )mL ,P <0 .0 5 ,(2 .3± 0 .3)Uvs(2 .7± 0 .5 )U ,P <0 .0 1。 3组病人术中 2h血压、心率、呼吸和动脉血氧饱和度比较 ,无显著差异 (P >0 .0 5 )。结论 :血凝酶在脊柱外科中可明显减少手术过程中的出血量 ,同时减少浓缩红细胞输入量 ,局部喷洒同静脉共同应用效果更加显著。

AIM: To observe hemostatic effect of hemocoagulase with different administration method in spinal operation. METHODS: Ninty patients receiving vertebral canal decompression procedure or lumbar discectomy operation were randomly divided into three groups. There were 30 patients in each group. Combination group received hemocoagulase,1 U,iv,15 min before operation and in combination with 2U topical perfusion during operation. Vein group received hemocoagulase,1 U,iv,15 min before operation and 2U,iv,gtt,during operation. No hemostatics was administrated in control group. Operation indicatio and anaesthesia method were the same among three groups. The blood pressure (BP),heart rate (HR),respiration rate (RR),arterial oxygen saturation ( S aO_2),bleeding volume and condensed RBC input volume during the operation in three groups were observed. RESULTS: Bleeding volume and condensed RBC input volume of combination group,vein group were obviously lower than those of control group ( P <0.01). And there was difference between combination group and vein group ((689± s 150) mL vs (803±186) mL, P <0.05 and(2.3±0.3) U vs (2.7±0.5) U, P <0.01). BP,HR,RR and S aO_2 of three groups during the operation were no significant difference( P >0.05). CONCLUSION: Hemocoagulase can reduce the bleeding and condensed RBC input volume in spinal operation. Hemocoagulase intravenous in combination with topical perfusion is more effective.