血凝酶对前列腺双极电切术围手术期凝血、纤溶功能的影响

Effect of hemocoagulase on coagulation and fibrinolytic function in the peri-operative period of BPH patients with PKRP

目的探讨血凝酶对前列腺增生(BPH)患者行双极电切术(PKRP)围手术期机体凝血、纤溶功能的影响。方法将60例BPH患者分为血凝酶组、止血芳酸组和生理盐水组,每组20例,观察术中、术后患者的出血量以及机体凝血、纤溶功能指标血小板计数(Plt)、红细胞压积(Hct)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fbg)、组织型纤溶酶原激活物(t-PA)、纤溶酶原激活剂抑制物(PAI-1)和D-二聚体(D-D)的变化。结果与止血芳酸组和生理盐水组相比,血凝酶组术中、术后3d出血量减少(P<0.05)。三组的APTT无明显变化(P>0.05);生理盐水组术中、术后第1天PT升高(P<0.05),止血芳酸组和血凝酶组的PT无明显变化(P>0.05);血凝酶组能维持Plt、Hct、Fbg、t-PA、PAI-1和D-D的相对稳定(P<0.05)。结论血凝酶能减少BPH患者PKRP围手术期出血量,对机体凝血、纤溶功能影响小,不会增加术后发生血栓形成的风险。

Objective To explore the effects of hemocoagulase on the coagulation and fibrinolytic function in the peri-operative period of benign prostatic hyperplasia（BPH） patients with plasmakinetic resection of the prostate（PKRP）.Methods 60 patients undergoing PKRP were divided into the hemocoagulase group,the P-aminomethylbenzoic acid（PAMBA） group and the normal saline（NS） group,with 20 patients in each group.Different medicines were adminstered to the groups.Hemorrhagic volume,body coagulation and fibrinolytic parameters were observed,including platelet（Plt）,hematocrit（Hct）,prothrombin time（PT）,activated partial thromboplastin time（APTT）,fibrogen（Fbg）,tissue-type plasminogen activator（t-PA）,plasminogen activator inhibitor-1（PAI-1） and D-Dimer（D-D）.Results Compared with the PAMBA and NS groups,average hemorhagic volumes in the hemocoagulase group were decreased（P 〈0.05）.There were no significant differences of APTT among the three groups（P 〉0.05）.Compared with the pre-operative,PT in NS gro increased during the operation and on the first post-operative day（P 〈0.05）,however,no significant differences of PT were identified in the PAMBA and hemocoagulase groups（P 〉0.05）.In the hemocoagulase group,relatively stable Plt,Hct,Fbg,t-PA,PAI-1 and D-D parameters（P 〈0.05） were shown.Conclusions Hemocoagulase can reduce hemorhagic volume in the peri-operative period of BPH patients with PKRP.With little effect on body coagulation and fibrinolytic function,it does not increase the risks of thrombosis after operation.