矛头蝮蛇血凝酶对膀胱癌TURBT术后止血的应用价值

Applied value of Heocoagulase Bothrops Atrox from agkistrodon halys venom in postoperative hemostasis of bladder cancer after TURBT

目的观察矛头蝮蛇血凝酶对经尿道膀胱肿瘤电切术(TURBT)术后止血的应用效果。方法选取98例行TURP手术治疗的膀胱癌患者,按照随机数字表法分为两组。常规组49例,术后予以常规电凝止血,试验组49例,术后经局部加用矛头蝮蛇血凝酶止血,比较两组的止血效果、凝血功能及预后情况。结果治疗后,试验组的术后出血量、膀胱冲洗时间、尿液转清时间及导尿管留置时间均低于常规组,差异有统计学意义(P<0.05)。试验组的APTT、PT、TT以及PAI-1、t-PA略高于常规组,但差异无统计学意义(P>0.05)。术后,试验组BC、Qmax均高于常规组,BSSS评分、术后并发症发生率低于常规组(P<0.05)。结论TURBT术后局部加用矛头蝮蛇血凝酶可在不影响患者凝血功能及纤溶系统功能的情况下,产生显著止血效果,对促进患者术后膀胱功能恢复并降低并发症发生风险均有积极意义。

Objective To observe the application effect Heocoagulase Bothrops Atrox on hemostasis after transurethral resection of bladder tumors(TURBT).Methods 98 cases of bladder cancer treated by TURP were divided into two groups using random mumber table method.49 cases in the conventional group were treated with routine electrocoagulation for hemostasis after operation,and 49 cases in the test group were treated with local application of Heocoagulase Bothrops Atrox from agkistrodon halys spear after operation.The hemostasis effect,coagulation function and prognosis of the two groups were compared.Results After treatment,the amount of postoperative bleeding,bladder flushing time,urine clearance time and catheter retention time in the test group were lower than those in the conventional group,with statistically significant differences(P<0.05),and the APTT,PT,TT,PAI-1,t-PA in the test group were slightly higher than those in the conventional group,with no statistically significant difference(P>0.05).The postoperative BC and Qmax in the experimental group were higher than those in the conventional group,while the BSSS score and postoperative complication rate were lower than those in the conventional group(P<0.05).Conclusion Local administration of Heocoagulase Bothrops Atrox after TURBT can produce significant hemostatic effects without affecting the coagulation function and fibrinolytic system function of patients,and has a positive significance in promoting postoperative bladder function recovery and reducing the risk of complications.