尖吻蝮蛇血凝酶在悬雍垂腭咽成形术中止血效果观察
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摘要
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 uulopalatopharyngoplasty under general anesthesia. In treatment group,intravenous drip of Agkistrodon acutus hemagglutinin2μ was injected 1 d before operation, and 1μ 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.
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 uulopalatopharyngoplasty under general anesthesia. In treatment group,intravenous drip of Agkistrodon acutus hemagglutinin2μ was injected 1 d before operation, and 1μ 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.
引文
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[11]Wei JM,Zhu MW,Zhang ZT,et al.A multicenter,phaseⅢtrial of hemocoagulase Agkistrodon:hemostasis,coagulation,and safety in patients undergoing a bdominal surgery[J].Chin Med J(Engl),2010,23(5):589-593.
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[2]Gutlal SS.Conservative treatment of obstructive sleep apnea:a case report[J].N Y State Dent J,2008,74(5):57-59.
[3]郭新刚,马小玲.2006-2008年我国止血药市场分析[J].中国药房、2010,21(1):9-11.
[4]中华医学会呼吸病学分会睡眠呼吸疾病学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(草案)[J].中华结核和呼吸杂志,2002,25(5):195-198.
[5]中华医学会耳鼻咽喉头颈外科学分会咽喉学组.阻塞性睡眠呼吸暂停低通气综合征诊断和外科治疗指南[J].中华耳鼻咽喉头颈外科杂志,2009,44(3):95-96.
[6]高学敏,王永炎,颜正华.中药学[M].北京.中国中医药出版社,2008:202;
[7]吕慧敏,李长龄,张翠兰,等.尖吻蝮蛇血凝酶的止血作用及其作用机制的研究[J].中国实验血液学杂志,2008,16(4),863-885.
[8]石光,庞建新,孔焕育,等.尖吻蝮蛇血凝酶药效评价及作用机制[J].中国新药杂志,2010,18(19),1706-1709.
[9]王睿,方翼,裴斐,等.静脉注射尖吻蝮蛇血凝酶在中国健康志愿者的药代动力学[J].中国临床药理学杂志,2006,22(4):422-425.
[10]米鹏程,黄莹,孔焕育,等.尖吻腹蛇血凝酶止血作用的机制[J].中国新药杂志,2013,22(11),1315-1319.
[11]Wei JM,Zhu MW,Zhang ZT,et al.A multicenter,phaseⅢtrial of hemocoagulase Agkistrodon:hemostasis,coagulation,and safety in patients undergoing a bdominal surgery[J].Chin Med J(Engl),2010,23(5):589-593.
[12]王睿,方翼,裴斐,等.静脉注射尖吻蝮蛇血凝酶Ⅰ期临床耐受性研究[J].中国药学杂志,2005,40(1):131-133.