凝血酶在预防乳腺微创旋切术后出血中的应用价值

Application value of thrombin in intraoperative and postoperative hemorrhage after Mammotome operation

目的评价术中局部使用凝血酶对乳腺微创旋切手术术后出血的影响。方法将该院2010年7月至2013年6月乳腺微创旋切手术术中活动性出血的40例患者随机分为凝血酶组和压迫止血组,每组20例。凝血酶组予以凝血酶500 U配10 mL生理盐水注射术腔,压迫止血组予以局部压迫止血,无活动性出血后分别予绷带加压包扎,术腔留置引流管接空针负压吸引48 h,记录两组术后出血量。结果凝血酶组术后48 h出血量2-12 mL,平均（7.13±2.61）mL,压迫止血组术后48 h出血量5-20 mL,平均（10.98±4.03）mL,两组比较,差异有统计学意义（P〈0.01）。结论对于乳腺微创旋切手术术中活动性出血患者,使用凝血酶相比单纯压迫止血能显著减少术后出血量,具有临床应用价值。

Objective To evaluate the effect of thrombin on the postoperative hemorrhage after Mammotome operation.Methods Forty patients of intraoperative active hemorrhage in Mammotome operation in the hospital from July 2010 to June2013 were randomly divided into thrombin group and compression hemostasis group,20 cases in each group. 500 U thrombin with10 mL normal saline was injected to the surgical cavity in thrombin group and local oppression was given compression hemostasis group. Both groups were added with bandage and pressure dressing after no active hemorrhage,and the indwelling drainage tube vacuum aspiration for 48 h to record the postoperative hemorrhage volume. Results The hemorrhage volume in the thrombin group 48 h after operation was 2-12 mL with the average volume of（7.13±2.61）mL,while the hemorrhage volume in compression hemostasis group 48 h after operation was 5-20 mL with the average volume of（10.98±4.03）mL,and the difference between the two groups was statistically significant（P〈0.01）. Conclusion For the patients of intraoperative active hemorrhage with Mammotome operation,the thrombin has better effect on reducing postoperative hemorrhage volume than simple compression with clinical application value.