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目的:研究不同剂量巴曲事用以减少术中出渗血量及对机体出凝血功能的影响。方法:60例ASA Ⅰ-Ⅱ级行择期全子宫切除术的病人,随机分为对照组(A组)、巴曲亭2KU组(B组)及巴曲亭4KU(C组)三组,切皮前5分钟分别予以生理盐水、巴曲亭2KU、巴曲亭4KU。分别于切皮前和术毕采血检测血浆凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原定量(FIB)及血常规检查,并测定术中出血量。结果:A组病人术毕Hb、RBC、PLT、Hct水平较给药前显著下降,PT、APTT有所延长,Fbg变化不明显。B、C组术毕FIB值较给药前显著下降,其他指标变化不大。组间比较,B、C组术毕Hb、RBC、PLT、Hct水平较A组显著升高,B、C组间无显著性差异。B、C组术毕FIB值较A组显著下降,两组间无显著性差异,三组间PT及APTT变化不明显。术中出血量A组为268.8±46.6ml,B组为183.4±37.3ml,C组为192.5±52.7ml。B、C组术中出血量较A组显著下降,B、C组间无明显差异。结论:术前应用巴曲亭2～4KU可显著改善病人的凝血功能,减少术中出血量。
OBJECTIVE: To study the effects of different doses of batroxobin to reduce the amount of bleeding during operation and the coagulation function of the body. Methods: Sixty ASA Ⅰ-Ⅱ patients undergoing elective hysterectomy were randomly divided into three groups: control group (A group), parotidectin 2KU group (B group) 5 minutes were given saline, Bat Trang 2KU, Barthe Pavilion 4KU. Plasma prothrombin time (PT), partial thromboplastin time (APTT), fibrinogen quantitation (FIB) and blood routine examination were performed before and after the skin incision. Blood loss was measured. Results: The levels of Hb, RBC, PLT and Hct at the end of operation in group A were significantly decreased compared with that before administration, while the levels of PT and APTT were prolonged and the changes of Fbg were not obvious. In group B and group C, the FIB value at the end of operation was significantly lower than that before administration, while the other indexes did not change much. Compared between groups, the levels of Hb, RBC, PLT and Hct in group B and C were significantly higher than those in group A, but there was no significant difference between group B and C. In group B and group C, the FIB value at the end of operation was significantly lower than that in group A, and there was no significant difference between the two groups. The changes of PT and APTT were not obvious among the three groups. The intraoperative blood loss was 268.8 ± 46.6ml in group A, 183.4 ± 37.3ml in group B and 192.5 ± 52.7ml in group C, respectively. The blood loss in group B and C was significantly lower than that in group A, and there was no significant difference between group B and C. Conclusion: Preoperative use of 2 ~ 4KU of trastuzumab can significantly improve the patient’s coagulation function and reduce the amount of intraoperative bleeding.