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目的:探讨血凝酶在长期抗凝患者经尿道前列腺电切术(TURP)术后出血治疗中的临床价值。方法:77例因各种原因长期抗凝的患者合并前列腺增生需接受TURP治疗,随机分为血凝酶组(42例)和止血敏组(35例),术后分别运用血凝酶和止血敏止血,比较两组的术后出血时间,并检测术前及术后凝血象及血常规。术后行双下肢血管彩超检查了解有无深静脉血栓形成。结果:血凝酶组术后出血时间明显低于止血敏组(P<0.05)。术后血凝酶组血小板计数较术前有所下降(P>0.05),PT、APTT无明显变化(P>0.05),而止血敏组PT、APTT较术前明显延长(P<0.05),血小板计数较术前下降(P>0.05)。术后血凝酶组无深静脉或冠脉血栓形成,无新的脑梗塞症状出现。止血敏组有3例发生单侧下肢水肿,其中2例彩超明确有深静脉血栓形成;另有1例有心绞痛发生。结论:血凝酶对需长期抗凝患者TURP术后出血有明显止血效果,且对凝血功能影响不明显,不会增加静脉或动脉血栓形成的风险。
Objective: To investigate the clinical value of hemagglutinin in the treatment of hemorrhage after transurethral resection of prostate (TURP) in patients with long-term anticoagulation. Methods: A total of 77 patients with long-term anticoagulation due to various reasons were treated with TURP. Patients were randomly divided into the hemagglutinin group (n = 42) and the Zhixue Min group (35 patients). After operation, hemagglutination enzyme and hemostasis Min hemostasis, bleeding time after the two groups were compared, and preoperative and postoperative coagulation and blood tests. Postoperative vascular lower extremity ultrasound examination to understand whether there is deep vein thrombosis. Results: The postoperative hemorrhage time in hemagglutinin group was significantly lower than that in Zhimian group (P <0.05). The platelet count of post-hemagglutination group was lower than that before operation (P> 0.05), PT and APTT had no significant change (P> 0.05), but PT and APTT of Zhixue group were significantly longer than those before operation (P <0.05) Platelet count decreased compared with preoperative (P> 0.05). Postoperative hemozyme group no deep vein or coronary thrombosis, no new symptoms of cerebral infarction. There were 3 cases of unilateral lower extremity edema in the hemostatic group, of which 2 cases were clearly diagnosed as deep vein thrombosis; another case had angina pectoris. CONCLUSION: Hemagglutinin has obvious hemostatic effect on TURP postoperative bleeding in patients with long-term anticoagulation, and has no obvious effect on coagulation function and does not increase the risk of venous or arterial thrombosis.