尖吻蝮蛇血凝酶在悬雍垂腭咽成形术中止血效果观察

Hemostatic Effect of Agkistrodon Acutus Hemagglutinin in Uvulopalatopharyngoplasty

目的观察尖吻蝮蛇血凝酶(HCA,商品名苏灵)在悬雍垂腭咽成形术(UPPP)中控制创面渗血的疗效。方法将本院自2010年8月-2015年6月收治的70例阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者随机分为治疗组(35例)和对照组(35例),均在全麻下行悬雍垂腭咽成形术,治疗组术前1d静脉滴注尖吻蝮蛇血凝酶2μ,术前30min肌肉注射1μ;对照组术前按常规处理。观察记录术中出血量和手术时间,同时观察治疗组凝血功能变化。结果治疗组术中出血量(60.8±20.6)mL与对照组(112.9±25.7)mL相比减少(P<0.01);治疗组手术时间(75±15)min与对照组(95±20)min相比缩短(P<0.01),治疗组凝血功能指标术前与术后差异无统计学意义。结论尖吻蝮蛇血凝酶对悬雍垂腭咽成形术创面有较好的止血作用,利于缩短手术时间,并且不影响凝血功能,有良好的安全性。

Objective To observe the hemostatic effect of Agkistrodon acutus hemocoagulin on bleeding in the operating area during the period of the uvulopalatalpharyngoplasty. Methods 70 cases of obstructive sleep apnea hypopnea syndrom （OSAHS） patients were randomly divided into treatment group and control group, 35 cases in each group. Both groups received uvulopalatopharyngoplasty under general anesthesia. In treatment group, intravenous drip ofAgkistrodon acutus hemagglutinin 2la was injected ld before operation, and llx was injected into 30 min before operation; control group was treated by routine treatment before operation. The amount of bleeding and the time of operation were recorded and the changes of coagulation function in treatment group was observed. Results The bleeding amount of treatment group was less compared with control group （P〈0.01）; the operating time of treatment group was shorter compared with control group （P〈0.01）, there was no statistically significant difference in blood coagulation function index of preoperative and postoperative of treatment group. Conclusion Agkistrodon acutus hemocoagulin has good hemostatic effect on uvulopalatopharyngoplasty, which is beneficial for shortening operation time and not affecting coagulation function and has good safety.