巴曲亭对脊柱手术的止血效果及患者出凝血功能的影响

Hemostatic effect and blood coagulation function of hemocoagulase in spinal operations

目的:研究巴曲亭用于脊柱手术中的止血效果及对患者凝血功能影响.方法:选择100例ASAⅠⅡ级脊柱择期手术患者,男性54例,女性46例,年龄18～65岁,随机分为巴曲亭组(n=50)和生理盐水对照组(n=50),巴曲亭组切皮前10minim巴曲亭1单位,iv2单位;对照组注射等量的生理盐水.在给药前和手术结束时分别抽取静脉血检测血浆凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原浓度(FIB)、血小板浓度(PLT);比较两组患者的术中出血量、输血量和术后24h引流量.结果:两组患者年龄、体质量和手术时间比较差异无统计学意义;对照组术后和术前相比PT,TT,APTT明显延长(P<0.05),巴曲亭组手术前后差异无统计学意义,术后组间比较差异有统计学意义(P<0.05);FIB和PLT在两组差异无统计学意义.巴曲亭组术中出血量、输入浓缩红细胞量及术后24h引流量明显减少,与对照组比较差异有统计学意义(P<0.05).结论:巴曲亭可以显著减少脊柱手术的出血量、输血量和术后24h引流量,但不影响患者出凝血功能.

AIM: To study the hemostatic effect and blood coagulation function of hemocoagulase in spinal operations. METHODS: One hundred ASA physical status Ⅰor Ⅱpatients (M 54, F 46, age 18-65 years) undergoing selective spinal surgeries were selected and randomly divided into two groups of 50 each: hemocoagulase group and saline group as control. Before operation, hemocoagulase (3 kU) was injected in hemocoagulase group and normal saline was injected in control group. The data compared between the two groups were prothrombin time (PT), thrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), blood platelet (PLT), bleeding volume during operation, transfusion volume and drainage volume 24h after operation. RESULTS: There was no significant difference in age, mass and operation time between the two groups (P>0.05). The PT, TT and APTT increased significantly after operation in control group (P<0.05). There was no significant difference in hemocoagulase group before and after operation. There was significant difference between the two groups (P<0.05). The bleeding and transfusion volume during operation and the drainage volume 24h after operation in hemocoagulase group were less than that in control group, with significant difference between the two groups (P<0.05). CONCLUSION: Hemocoagulase can reduce the bleeding, transfusion volume and drainage volume 24h after operation in spinal operation with no significant effect on the coagulation function.