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目的评价尖吻蝮蛇血凝酶在泌尿外科后腹腔腹腔镜手术围手术期应用的有效性与安全性。方法 126例后腹腔镜手术病例随机分为A、B、C 3组各42例,分别于术前15 min及术后3 d静脉注射尖吻蝮蛇血凝酶2 U、血凝酶2 kU、酚磺乙胺2.0 g。3组均于术前及术后第3天记录术中失血量与术后引流量,检测血常规、肝肾功能以及凝血功能指标。结果 A组术中失血量和术后引流量分别为(112±61)和(113±55)mL,B组分别为(120±58)和(127±62)mL,与C组(198±67)和(250±52)mL比较,均呈显著性下降(P<0.01),A组与B组比较差异无统计学意义(P>0.05)。3组病例血常规指标A组RBC、HGB、PLT分别为(0.27±0.11)×1012.L-1,(7.19±0.90)g.L-1,(12.24±0.82)×109.L-1,B组分别为(0.29±0.01)×1012.L-1,(7.21±0.78)g.L-1,(13.60±0.88)×109.L-1,与C组(0.48±0.12)×1012.L-1,(10.01±1.22)g.L-1,(19.71±1.65)×109.L-1比较,差异有统计学意义(P<0.05),A组与B组比较均差异无统计学意义(P>0.05)。3组病例肝肾功能、凝血功能指标比较均差异无统计学意义(P>0.05)。结论后腹腔腹腔镜手术围手术期应用尖吻蝮蛇血凝酶安全、有效。
Objective To evaluate the effectiveness and safety of perioperative application of Apatheria serrata in the post-laparoscopic laparoscopic surgery of urology. Methods 126 cases of retroperitoneal laparoscopic surgery were randomly divided into A, B, C 3 group of 42 cases, respectively, 15 min before and 3 d after the intravenous injection of Agkistrodon ch apolyase 2 U, 2 kU hemagglutinin , Phenylethanolamide 2.0 g. 3 groups were recorded before surgery and postoperative day 3 blood loss and postoperative drainage, blood tests, liver and kidney function and coagulation function indicators. Results The intraoperative blood loss and postoperative drainage were (112 ± 61) and (113 ± 55) mL in group A, (120 ± 58) and (127 ± 62) mL in group B, 67) and (250 ± 52) mL, respectively. There was no significant difference between group A and group B (P> 0.05). The RBC, HGB and PLT in group A were (0.27 ± 0.11) × 1012.L-1, (7.19 ± 0.90) gL-1, (12.24 ± 0.82) × 109.L-1, (0.29 ± 0.01) × 1012.L-1, (7.21 ± 0.78) gL-1 and (13.60 ± 0.88) × 109.L-1, respectively, (10.01 ± 1.22) gL-1, (19.71 ± 1.65) × 109.L-1, the difference was statistically significant (P <0.05), there was no significant difference between group A and group B (P> 0.05) . There was no significant difference in liver and kidney function and coagulation function between the three groups (P> 0.05). Conclusions Retroperitoneal laparoscopic surgery perioperative application of Agkistrodon halysii coagulation enzyme is safe and effective.