氨甲环酸注射液与注射用血凝酶在宫颈癌根治手术中止血效果的比较观察

Comparison and observation on the hemostatic effects of tranexamic acid injection and hemocoagulase injection in cervical cancer radical surgery

目的:比较氨甲环酸注射液和注射用血凝酶在宫颈癌根治手术中的止血效果。方法:随机将40例宫颈癌Ⅰb1期患者分成氨甲环酸组(20例)和注射用血凝酶组(20例)。注射用血凝酶组于术前1天晚、术前1 h、15 min各肌肉注射1 kU;氨甲环酸注射液组于手术开始时及手术2 h时各静脉滴注1 g。比较两组患者手术时间,术中出血量,手术前后的凝血酶原时间(PT)、血红蛋白量(Hb)、血小板(PLT)、纤维蛋白降解产物(FDP)。结果:两组患者手术时间、术后PT与术前比较差异均无统计学意义。氨甲环酸注射液组术中出血量小于注射用血凝酶组(P<0.05)。两组患者术后Hb与术前相比均减少,但氨甲环酸注射液组减少量小于注射用血凝酶组(P<0.05)。氨甲环酸注射液组术后FDP与术前比较差异无统计学意义,而注射用血凝酶组术后FDP较术前升高(P<0.05)。注射用血凝酶组术后PLT少于术前(P<0.05)。结论:氨甲环酸注射液术中止血效果优于注射用血凝酶,能有效减少宫颈癌根治手术术中出血量,并可能有潜在的预防DIC的作用。

Objective：To compare the hemostatic effects of tranexamic acid injection and hemocoagulase injection in cervical cancer radical surgery. Methods：40 cases with cervical cancer of stageⅠb1 were divided into tranexamic acid injection group（20 cases） and hemocoagulase injection group（20 cases）.The cases in hemocoagulase injection group were treated with intramuscular injection of hemocoagulase（1 KU） on the day before operation,one hour and 15 minutes before operation;the cases in tranexamic acid injection group were treated with intravenous injection of tranexamic acid（1 g） at the beginning of the operation and two hours after the beginning.The operation times,the amounts of blood loss during pregnancy,prothrombin times（PTs） before and after treatment,the levels of hemoglobin（Hb）,the counts of platelets（PLT） and the levels of fibrin degradation products（FDP） in the two groups were compared. Results：There was no significant difference in operation time between the two groups;there was no significant difference in PT before and after treatment;the amount of blood loss during pregnancy in tranexamic acid injection group was lower than that in hemocoagulase injection group（P0.05）.In the two groups,the levels of Hb after treatment were significantly lower than those before treatment,but the decrease range in tranexamic acid injection group was smaller than that in hemocoagulase injection group（P0.05）.In tranexamic acid injection group,there was no significant difference in the level of FDP before and after treatment;while in hemocoagulase injection group,the level of FDP after treatment was significantly higher than that before treatment（P0.05）.In hemocoagulase injection group,the count of PLT after treatment was significantly lower than that before treatment（P0.05）. Conclusion：The hemostatic effect of tranexamic acid injection is better than that of hemocoagulase injection during operation,tranexamic acid injection can reduce the amount of blood loss during pregnancy in cervical cancer radical surgery and has a potential effect on prevention of DIC.