矛頭蝮蛇血凝酶靜脈注射聯合局部使用對股骨骨折手術患者的止血效果

黃發 吳志娜 孫立光

摘要：目的 ?探討矛頭蝮蛇血凝酶靜脈注射聯合局部使用對股骨骨折手術患者的止血效果。方法 ?選取2018年12月～2019年12月我院收治的股骨骨折手術患者80例作為研究對象，按照隨機數字表法分為對照組和研究組，每組40例。對照組單純靜脈注射用矛頭蝮蛇血凝酶，研究組注射用矛頭蝮蛇血凝酶靜脈注射聯合局部使用，比較兩組止血情況（切口出血量、切口止血時間、單位面積出血量）、術中出血量、術后1 d引流量、圍術期凝血因子指標[凝血酶原時間（PT）、凝血酶時間（TT）、活化部分凝血活酶時間（APTT）]。結果 ?研究組切口出血量、切口止血時間、單位面積出血量優于對照組[（5.12±3.05）g vs（8.15±2.69）g]、[（125.88±41.72）s vs（190.32±55.04）s]、[（0.28±0.13）g/cm2 vs（0.38±0.15）g/cm2]，差異有統計學意義（P<0.05）;研究組術中出血量、術后1 d引流量低于對照組，差異有統計學意義（P<0.05）;兩組術前、術后1 d PT、TT、APTT比較，差異無統計學意義（P>0.05）。結論 ?注射用矛頭蝮蛇血凝酶靜脈注射聯合局部使用應用于股骨骨折手術患者可進一步提升止血效果，減少術中出血量，有利于促進股骨關節恢復，且不會引起凝血功能異常。

關鍵詞：注射用矛頭蝮蛇血凝酶;靜脈注射;股骨骨折手術;止血

中圖分類號：R683 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 文獻標識碼：A ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? DOI：10.3969/j.issn.1006-1959.2020.17.045

文章編號：1006-1959（2020）17-0152-03

Abstract：Objective ?To investigate the hemostatic effect of intravenous injection of Hemocoagulase Bothrops Atrox combined with local use on patients with femoral fracture surgery.Methods ?80 cases of femoral fracture surgery patients admitted to our hospital from December 2018 to December 2019 were selected as the research objects， and were divided into the control group and the study group according to the random number table method， with 40 cases in each group. In the control group， Hemocoagulase Bothrops Atrox for intravenous injection alone， and Hemocoagulase Bothrops Atrox for intravenous injection in the study group combined with local use. The two groups were compared for hemostasis （incision bleeding， incision hemostasis time， bleeding per unit area）， surgery amount of bleeding， the amount of drainage on the first day after surgery， and the perioperative coagulation factor indexes [prothrombin time （PT）， thrombin time （TT）， activated partial thromboplastin time （APTT）].Results ?The study groups incision bleeding， incision hemostasis time， and unit area bleeding were better than those of the control group [（5.12±3.05）g vs （8.15±2.69）g]， [（125.88±41.72）s vs （190.32±55.04）s]， [（0.28±0.13）g/cm2 vs （0.38±0.15）g/cm2]， the difference was statistically significant （P<0.05）; the amount of blood loss during operation and the amount of drainage 1 d after operation in the study group were lower than those in the control group，there was statistical significance （P<0.05）; there was no significant difference in PT， TT， APTT before and 1 d after operation between the two groups （P>0.05）.Conclusion ?The intravenous injection of Hemocoagulase Bothrops Atrox for injection combined with local used in patients with femoral fracture surgery could further improve the hemostatic effect， reduce intraoperative blood loss， and promote the recovery of the femoral joint without causing abnormal blood coagulation.

Key words：Hemocoagulase Bothrops Atrox for injection;Intravenous injection;Femoral fracture surgery;Hemostasis

股骨骨折手術是一項有創性手術方法，存在出血量較大的風險，不僅增加手術難度、影響預后，嚴重時甚至會對患者生命安全構成重大威脅[1]。另外，股骨骨折手術者主要以老年患者為主，對失血耐受性較差，不利于術后股骨頭關節恢復。因此，如何合理控制術中出血量且提高止血效果對保障手術有效性、安全性及患者康復具有重大意義。注射用矛頭蝮蛇血凝酶因其具有快速減少出血、止血等功效[2，3]，已被廣泛應用于醫學各個領域，但不同使用方法對其治療效果存在差異。……