Suzuki R, Matsuhashi M, Kuwahara T, Kase T
Hinyokika Kiyo. 1986 Oct;32(10):1461-4.
We describe the usefulness of topical application of thrombin as a hemostatic aid in prostatic surgery. We used a specially designed 3-way bag catheter, one way of which opened to the prostatic fossa. After enucleation of the prostate suprapubically, we inserted the bag catheter into the bladder before any hemostatic procedure was performed on the prostatic fossa, inflated the bag, gently pulled down the catheter against the prostatic fossa, and then injected the thrombin solution (5,000 units/5 cc. X 2) into the fossa. Fifty patients were randomized into two groups; the "thrombin" method group and the hemostatic "ligature" group, and compared. The "thombin" method group showed statistically significant superiority to the "ligature" method group in reduced operation time and operative bloodloss. On the contrary, the duration of postoperative hematuria was longer with the "thrombin" method but not significantly. Even the prolonged duration of hematuria, however, produced no clinical problems. Hypofibrinogenemia and poor conditions of drug storage lowered its efficacy. These points should be remembered when using thrombin.
我们描述了在前列腺手术中局部应用凝血酶作为止血辅助手段的效用。我们使用了一种特殊设计的三腔导尿管，其中一个腔通向前列腺窝。经耻骨上前列腺摘除术后，在对前列腺窝进行任何止血操作之前，我们将袋状导尿管插入膀胱，充盈气囊，将导尿管轻轻向下拉使其紧贴前列腺窝，然后将凝血酶溶液（5000单位/5毫升×2）注入前列腺窝。50例患者被随机分为两组：“凝血酶”法组和止血“结扎”组，并进行比较。“凝血酶”法组在缩短手术时间和减少术中出血量方面显示出在统计学上显著优于“结扎”法组。相反，“凝血酶”法组术后血尿持续时间较长，但差异不显著。然而，即使血尿持续时间延长，也未产生临床问题。低纤维蛋白原血症和药物储存条件不佳降低了其疗效。使用凝血酶时应牢记这些要点。
