注射用白眉蛇毒血凝酶局部应用对PPH术出血疗效的观察

Observation of bleeding after PPH with hemocoagulase for injection

目的:评价白眉蛇毒血凝酶(BT)对微创痔疮手术(PPH)术出血疗效的作用效果。方法:选择行PPH痔疮患者共110例,随机将其分为对照组和观察组各55例,对照组术后塞入凡士林纱布止血,观察组在凡士林纱布上均匀喷洒白眉蛇毒血凝粉。比较两组平均手术时间、术后出血量和伤口愈合时间,凝血四项包括凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB),血小板计数,ELISA法检测血浆纤维蛋白肽A和B含量。结果:两组平均手术时间比较无统计学差异(P>0.05),但观察组术后出血量和伤口愈合时间明显小于对照组,差异有统计学意义(P<0.05)。两组凝血四项和血小板计数比较无统计学差异(P>0.05),但观察组血浆纤维蛋白肽A含量明显高于对照组(P<0.05),纤维蛋白肽B含量也无统计学差异(P>0.05)。结论:BT可明显降低PPH术后出血,不影响凝血纤溶平衡,不易形成血栓,可能通过增加纤维蛋白肽A含量发挥作用,有较高的应用安全性和有效性。

Objective:To study effect of bleeding after Procedure for prolapse and hemorrhoids(PPH)with hemocoagulase for injection(BT).Methods:A total of 110 consecutives as hemorrhoids patients for PPH were enrolled and divided randomly into control and observation groups,each of 55 cases;the control group was injected with Vaseline gauze to stop bleeding,and the observation group was evenly sprayed with whiteheaded venom blood clot on vaseline gauze.Then to compare differences of mean operation time,postoperative bleeding volume and wound healing time;coagulation functions including Prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB);platelet count,plasma fibrinpeptide A and B contents with ELISA.Results:The operation time in the two groups was no statistical difference(P>0.05),while bleeding volume and wound healing time in observation group were both significantly less than control group(P<0.05).The coagulation functions and platelet count in the two groups was no statistical difference(P>0.05),but,fibrinpeptide A content in observation group was significantly higher(P<0.05),fibrinpeptide B content in the two groups was no statistical difference(P>0.05).Conclusion:BT can greatly reduce bleeding after PPH,without influencing coagulation and fibrinolysis balance,not easily form thrombus,may increase fibrinpeptide A content;which is better security and effectiveness.