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目的探讨血凝酶对前列腺增生(BPH)患者行双极电切术(PKRP)围手术期机体凝血、纤溶功能的影响。方法将60例BPH患者分为血凝酶组、止血芳酸组和生理盐水组,每组20例,观察术中、术后患者的出血量以及机体凝血、纤溶功能指标血小板计数(Plt)、红细胞压积(Hct)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fbg)、组织型纤溶酶原激活物(t-PA)、纤溶酶原激活剂抑制物(PAI-1)和D-二聚体(D-D)的变化。结果与止血芳酸组和生理盐水组相比,血凝酶组术中、术后3d出血量减少(P<0.05)。三组的APTT无明显变化(P>0.05);生理盐水组术中、术后第1天PT升高(P<0.05),止血芳酸组和血凝酶组的PT无明显变化(P>0.05);血凝酶组能维持Plt、Hct、Fbg、t-PA、PAI-1和D-D的相对稳定(P<0.05)。结论血凝酶能减少BPH患者PKRP围手术期出血量,对机体凝血、纤溶功能影响小,不会增加术后发生血栓形成的风险。
Objective To investigate the effect of hemagglutinin on coagulation and fibrinolytic function in patients with benign prostatic hyperplasia (BPH) undergoing bipolar resection (PKRP). Methods Sixty BPH patients were divided into hemagglutinin group, hemostatic aromatase group and normal saline group, with 20 cases in each group. The amount of hemorrhage and the indexes of platelet count (Plt) , Hematocrit (Hct), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fbg), tissue plasminogen activator (t-PA), plasmin Changes in activator inhibitor (PAI-1) and D-dimer (DD). Results Compared with hemostatic aromas and normal saline groups, hemorrhagic volume decreased during and after operation in the hemagglutinin group (P <0.05). There was no significant change in APTT among the three groups (P> 0.05). PT in the saline group was significantly higher than that on the first day after operation (P <0.05) 0.05). The hemagglutinin group maintained relatively stable Plt, Hct, Fbg, t-PA, PAI-1 and DD (P <0.05). Conclusion Hemagglutinin can reduce perioperative blood loss of PKRP in patients with BPH, and has little effect on coagulation and fibrinolytic function of the body, and does not increase the risk of postoperative thrombosis.