摘要【目的】探讨内镜下注射蛇毒血凝酶对上消化道出血患者凝血功能及血液流变学的影响。【方法】选择2015年7月至2016年6月本院收治的上消化道出血患者136例为研究对象,随机分为观察组和对照组各68例。对照组采用内镜下喷洒和注射1∶10000肾上腺素,观察组在对照组的基础上注射蛇毒血凝酶,比较两组止血效果、凝血功能、血液流变学、不良反应等指标。【结果】观察组治疗有效率为95.59%明显高于对照组的85.29%,手术率为1.47%明显低于对照组的10.29%(均P<0.05);治疗3 d,观察组患者凝血酶原时间(PT)、部分凝血活酶时间(APTT)明显短于对照组,血小板(PLT)、纤维蛋白原(FIB)明显高于对照组(均P<0.05),全血高切黏度、全血低切黏度、红细胞压积明显高于对照组,血沉明显低于对照组(均P<0.05);两组腹痛加重、发热等并发症比较无统计学义(7.35% vs 4.41%,P<0.05)。【结论】内镜下注射蛇毒血凝酶有助于提高上消化道出血患者止血效果,降低手术率,其机制可能与改善患者凝血功能、调节血液流变学等因素有关。
Abstract：【Objective】To investigate the effect of endoscopic injection of snake venom hemocoagulase on coagulation function and hemorheology in patients with upper gastrointestinal hemorrhage.【Methods】One hundred and thirty-six patients with upper gastrointestinal bleeding admitted to our hospital from July 2015 to June 2016 were selected as the study subjects, and randomly divided into observation group and control group with 68 cases in each group. The control group was sprayed and injected with 1:10000 epinephrine under endoscope. The observation group was injected with snake venom hemocoagulase on the basis of the control group. The hemostatic effect, coagulation function, Hemorheology and adverse reactions were compared between the two groups.【Result】The effective rate of the observation group was 95.59% higher than 85.29% of the control group, and the operative rate was 1.47% lower than 10.29% of the control group (all P<0.05); after 3 days of treatment, the prothrombin time (PT) and partial thromboplastin time (APTT) of the observation group were significantly shorter than those of the control group, and the platelet (PLT) and fibrinogen (FIB) were significantly higher than those of the control group (all P<0.05). High shear viscosity, whole blood low shear viscosity and hematocrit were significantly higher than those of the control group, and ESR was significantly lower than those of the control group (all P<0.05). Complications such as abdominal pain and fever in the two groups had no statistical significance (7.35% vs 4.41%, P<0.05).【Conclusion】Endoscopic injection of snake venom hemagglutinin can improve the hemostatic effect and reduce the operation rate in patients with upper gastrointestinal hemorrhage. The mechanism may be related to the improvement of blood coagulation function and the regulation of hemorheology.
黄林. 内镜下注射蛇毒血凝酶对上消化道出血凝血功能及血液流变学的影响[J]. 医学临床研究, 2019, 36(6): 1056-1058.
HUANG Lin. Effect of Endoscopic Injection of Snake Venom Hemocoagulase on Coagulation Function and Hemorheology in Upper Gastrointestinal Hemorrhage. JOURNAL OF CLINICAL RESEARCH, 2019, 36(6): 1056-1058.
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2019, Vol. 36 
