长期抗凝抗血小板乳腺癌患者术腔应用矛头蝮蛇血凝酶止血效果的临床研究

Clinical Study of Hemostatic Effect of Hemocoagulase Bothrops Atrox in Operation Cavity of Breast Cancer Patients with Long Term Anticoagulation and Antiplatelet

目的:探讨在长期抗凝抗血小板乳腺癌手术患者术腔中使用矛头蝮蛇血凝酶的止血效果和安全性。方法:选取2012年4月至2018年4在我科行手术治疗并符合纳入标准的乳腺癌患者,随机分成使用矛头蝮蛇血凝酶的试验组和不使用矛头蝮蛇血凝酶的对照组。记录两组创面止血时间、出血量、术后引流量;比较血容量、凝血功能的变化,分析临床结局指标。结果:纳入123例,试验组60例,对照组63例。试验组在止血时间、单位面积渗血量、拔管时间、术后2 d内引流量和总引流量优于对照组(P<0.05);两组治疗前在血红蛋白、红细胞压积、血小板最大聚集率的比较,差异无统计学意义(P>0.05)而术后试验组上述指标优于对照组(P<0.05)。两组凝血功能、并发症比较,差异无统计学意义(P>0.05)。结论:在长期需抗血小板抗凝乳腺癌患者的术腔中应用矛头蝮蛇血凝酶有确切的止血效果且对凝血功能无明显影响,未增加动静脉血栓形成的风险,有较高的安全性。

Objective To evaluate the hemostatic effect and safety of Hemocoagulase Bothrops Atrox in operation cavity of breast cancer patients with long term anticoagulation and antiplatelet.Methods From April 2012 to April 2018,breast cancer patients who underwent surgical treatment in our department and met the inclusion criteria were randomly divided into an experimental group using Hemocoagulase Bothrops Atrox and a control group without using Hemocoagulase Bothrops Atrox.The hemostatic time,bleeding volume and postoperative drainage volume of the two groups were recorded.The changes of blood volume and coagulation function were compared,and the clinical outcome indicators were analyzed.Results123 cases were included,60 cases in the experimental group and 63 cases in the control group.There was no significant difference in hemoglobin,hematocrit and platelet aggregation rate between the two groups before treatment(P>0.05),but the above indexes in the experimental group were better than those in the control group after operation(P<0.05).There was no significant difference in coagulation function and complications between the two groups(P>0.05).Conclusion The application of spearhead hemocoagulase in the surgical cavity of breast cancer patients requiring anti-platelet anticoagulation has definite hemostatic effect and has no obvious effect on coagulation function.It does not increase the risk of arteriovenous thrombosis and has higher safety.