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静脉滴入注射用血凝酶过敏一例

Investigation on the Effects of Hemocoagulase in the Treatment of Upper Gastrointestinal Hemorrhage

目的:观察用白眉蛇毒血凝酶(邦亭)治疗上消化道出血的疗效。方法 上消化道出血患者90例,随机分为治疗组和对照组,所有病例均给予扩容及调整水电解质紊乱,静滴奥美拉唑42.6mg,每日1次;静滴卡络磺钠60mg,每日1次,重度贫血者予输血。治疗组再应用邦亭4 KU加生理盐水20mL口服,每日2次,对照组用去甲肾上腺素8mg加生理盐水90mL,每日分3次口服。结果 治疗组总有效率93.75%,对照组总有效率8095%,两组临床疗效差异有统计学意义(Plt;0.05)结论:白眉蛇毒血凝酶是一种有效的、安全的治疗上消化道出血的药物,在临床止血治疗中值得推广应用。

Efficacy and Safety of Hemocoagulase on Surgical Incision: A Systematic Review

ObjectiveTo evaluate the efficacy and safety of all kinds of hemocoagulase on operative incisions. MethodsDatabases including Web of Science, MEDLINE, EMbase, EBSCO, PubMed, CNKI, WanFang Data and VIP were electronically searched to collect randomized controlled trials (RCTs) about hemocoagulase on operative incisions from the inception to June 20th, 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.2 software. ResultsA total of 16 RCTs involving 1 867 patients were included. The results of meta-analysis showed that, compared with the control group, the hemostatic time (MD=-37.84, 95%CI -52.72 to -22.96, P<0.000 01), blood loss volume per unit area (MD=-0.09, 95%CI -0.10 to -0.07, P<0.000 01), PT of the first postoperative day (MD=-0.37, 95%CI -0.65 to -0.09, P=0.009) were significantly shorter in the hemocoagulase group. However, no significant differences were found in APTT, TT and FIB between two groups. ConclusionHemocoagulase can reduce hemostatic time and blood loss volume in surgical incisions. Due to the limited quantity and quality of the included studies, the above conclusion needs to be further verified by more high quality studies.

硫糖铝混悬凝胶混合血凝酶与血管夹用于防治内镜下息肉切除术后出血的随机对照研究

目的 探讨硫糖铝混悬凝胶混合血凝酶用于防治内镜下息肉切除术后出血的临床效果。 方法 纳入 2014 年 4 月—2015 年 3 月在消化内镜中心行内镜检查发现直结肠息肉，并行内镜下肠道息肉黏膜切除术患者 112 例，随机分成药物组和血管夹组，每组各 56 例，分别予以术后创面喷洒硫糖铝混悬凝胶混合血凝酶及血管夹止血处理，观察两种方法操作时间、止血成功率、术后再出血的发生率及创面愈合情况。 结果 药物组和血管夹组分别有 15 例和 13 例出现术中即时出血，两组差异无统计学意义（P>0.05）。两组术中观察均成功止血，未追加其他止血方法。药物组和血管夹组平均操作时间分别为（58±16）、（192±94） s，两组差异有统计学意义（P<0.05）。术后观察，药物组无再出血，血管夹组 1 例再出血，两组差异无统计学意义（P>0.05）。两组患者术后 1 个月复查创面均愈合良好。 结论 硫糖铝混悬凝胶混合血凝酶用于防治内镜下息肉切除术后出血是一种简单、经济、有效的止血方法。

Effectiveness of haemocoagulase agkistrodon versus tranexamic acid and sodium chloride in the prevention and treatment of perioperative bleeding: a real-world study

ObjectiveTo compare the effectiveness of haemocoagulase agkistrodon and tranexamic acid and sodium chloride in the prevention and treatment of perioperative bleeding in a real world setting. MethodsA research database was constructed based on the records of inpatient visits using haemocoagulase agkistrodon and tranexamic acid and sodium chloride according to the SuValue® database from January 1, 2016 to December 31, 2020. The patients were divided into two groups according to the different interventions. After matching with a 1∶1 propensity score, the effectiveness of two groups was compared. ResultsA total of 858 patients were included in each of the two groups, and there was no statistically significant difference in baseline characteristics between the two groups (P>0.05). Research results showed that patients using haemocoagulase agkistrodon had significantly reduced length of hospital stay, decrease in hematocrit, average estimated surgical bleeding, and decrease in hemoglobin (P<0.01). ConclusionHaemocoagulase agkistrodon has better effectiveness than tranexamic acid and sodium chloride for reducing perioperative blood loss based on current real world evidence.