立止血在高血压脑出血围手术期应用预防再出血疗效观察

Clinical Observation of Reptilase in Preventing Rehemorrhage During Perioperation of Hypertensive Intracerebral Hemorrhage

目的:探讨立止血在高血压脑出血围手术期应用预防再出血的临床可行性及效果。方法:120例住院需手术治疗的高血压脑出血患者随机分为治疗组和对照组,各60例。治疗组入院后立即给予立止血1.0ku静脉推注,1.0ku肌肉注射。术前准备后在全麻插管下行开颅血肿清除术,手术过程中再静脉注射立止血2.0ku,术毕当日至第3天,每日静脉注射立止血两次,每次1.0ku。对照组:术前术后常规给予止血敏、止血芳酸治疗,连用3d,其他治疗方法与治疗组相同。观察两组间手术后再出血率,两组间手术止血时间以及不同手术止血时间与再出血率的关系。结果:手术止血时间超过3h者术后再出血率明显增高。治疗组与对照组相比手术时间明显缩短,术后再出血率下降,两组间差异显著。结论:立止血在高血压脑出血围手术期应用能明显缩短手术中止血时间,明显降低术后再出血发生率,提高了高血压脑出血手术治疗成功率。

Objective：To evaluate feasibility and effectiveness of reptilase in preventing rehemorrhage in perioperation of hypertensive intracerebral hemorrhage.Method：120 patients with hypertensive intracerebral hemorrhage were randomly divided into treatment group（n=60） and control group（n=60）.In treatment group,reptilase was administered 1.0 ku intravenously and 1.0 ku intramuscularly immediately after admission,2.0 ku intravenously during hematoma exacuation,and 1.0 ku intravenously twice daily for three days after operation.In control group,aglumin and carbenzamine were adimistered routinely in preoperation and postoperation for three days.Result：Over 3 hours haemostasis time by operation were associated with higher postoperative rehemorrhage rate.The treatment group was significantly shorter in operative time,and lower postoperative bleeding rate,compared with the control group.There’s significant difference beween two groups Conclusion：Reptilase can significantly shorten hemostasis time of surgery,significantly reduce the incidence of postoperative bleeding in perioperation of hypertensivc intracerebral hemorrhage.