白眉蛇毒血凝酶联合氨甲环酸对经尿道前列腺汽化电切术术中及术后出血的影响

Impact of hemocoagulase and tranexamic acid on transurethral resection and electro- vaporization of prostate of intraoperative and postoperative bleeding

目的探讨白眉蛇毒血凝酶联合氨甲环酸对经尿道前列腺汽化电切术(TURP)术中及术后出血的影响。方法选取2014年10月—2015年8月苏州大学附属第一医院收治的良性前列腺增生患者48例,按入院先后顺序分为试验组与对照组,各24例。两组患者术前予以氨甲环酸,试验组患者术前予以白眉蛇毒血凝酶。观察两组患者手术情况、手术时间、切除每克前列腺出血量、术后止血时间、手术前后24h凝血常规〔血浆凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)、血浆纤维蛋白原(Fib)、D-二聚体〕。结果两组患者均未发生严重并发症;试验组患者手术时间、术后止血时间短于对照组,切除每克前列腺出血量少于对照组,差异有统计学意义(P<0.05);手术前后两组患者PT、APTT、Fib、D-二聚体比较,差异无统计学意义(P>0.05)。结论白眉蛇毒血凝酶联合氨甲环酸可减少TURP术中及术后出血,且安全性好。

Objective To explore the impact of hemocoagulase and tranexamic acid on intraoperative and postoperative bleeding of transurethral resection and electro- vaporization of prostate( TURP). Methods A total of 48 patients with benign prostatic hyperplasia were selected in the First Hospital Affiliated to Suzhou University from October 2014 to August 2015,according to the order in hospital,they were divided into experimental group and control group,24 cases in each group. Two group were given tranexamic acid,experimental group were given hemocoagulase. Operative situation,operation time,resection of the prostate blood loss per gram,operation hemostatic time,before and after operation 24 h coagulation conventional 〔plasma prothrombin time( PT),activated partial thromboplastic time( APTT),plasma fibrinogen( Fib),D- dimer〕between the two groups were observed. Results The two groups had no complication during treatment; operation time and operation hemostatic time of experimental group were shorter than those ofcontrol group,resection of the prostate blood loss per gram of experimental group were ledd than those ofcontrol group( P < 0. 05); before and after operation PT,APTT,Fib,D- dimer showed no significant differences between the two groups( P > 0. 05). Conclusion Hemocoagulase and tranexamic acid have notable curative effect in reducing intraoperative and postoperative bleeding of TURP,have good safety.