尖吻蝮蛇血凝酶在先天性心脏病患儿术中应用的安全性及有效性

The safety and effectiveness of agkistrodon hemocoagulase in children with congenital heart disease operation

目的评价尖吻蝮蛇血凝酶在先天性心脏病(congential heart disease,CHD)患儿术中应用的安全性及有效性。方法将60例需手术的先天性心脏病患儿随机分为两组,每组30例,A组在体外循环结束肝素拮抗后给予尖吻蝮蛇血凝酶1U,B组给予同等剂量的生理盐水,比较两组的创面出血量、术后24 h的胸腔引流量、出血时间及术后第3天的血常规、凝血功能、肝肾功能和不良反应。结果 A组在出血时间、创面出血量、术后24 h胸腔引流量均显著低于B组(P<0.05)。A组术后第3天的凝血功能、血常规、肝肾功能与术前比较差异无统计学意义,与B组比较差异也无统计学意义(P>0.05)。全组无不良反应发生。结论尖吻蝮蛇血凝酶在先天性心脏病患儿术中的应用是安全有效的。

Objective To evaluate the safety and effectiveness for agkistrodon hemocoagulase used in congenital heart disease（CHD） pediatric patients intraoperative.Methods 60 pediatric patients with congenital heart disease scheduled for elective open-heart surgery were randomly divided into two group with 30 pediatric patients each group.Group A was given 1 U of agkistrodon hemocoagulase enzyme at the end of CPB after heparin antagonism,group B was given the same dose of saline.The bleeding wound,postoperative 24-hour chest drainage,bleeding time,the third day after operation of the blood routine,coagulation and liver and kidney function and adverse reactions of the two groups were compared.Results The bleeding time,wound bleeding and postoperative 24-hour chest drainage of group A were significantly lower than the group B（P 0.05）.The group A,which of the clotting function,blood routine,liver and kidney function on the 3rd postoperative day compared with preoperative was not significant different,compared with the group B was not statistically different（P 0.05）.The whole group had no adverse reactions.Conclusion Agkistrodon hemocoagulase in patients with congenital heart surgery in children is safe and effective.