Lu Songsong, Han Man, Song Ying, Liu Chen
Int J Clin Pharmacol Ther. 2020 Jun;58(6):351-353. doi: 10.5414/CP203707.
Hemocoagulase is often used for hemostasis in patients with bleeding and hemorrhagic diseases, and to avoid or stanch bleeding after surgery. Herein, three patients with hepatic diseases suffering from hypofibrinogenemia were treated with hemocoagulase agkistrodon (HCA) in Peking University People's Hospital during September 2018. All the 3 patients were chronic hepatitis B patients: Patient 1 presented with hepatic carcinoma and chronic hepatitis B, and right hepatectomy was performed; patient 2 presented with chronic hepatitis B and gastrointestinal bleeding; patient 3 presented with chronic hepatitis B, acute liver failure with hematemesis, and was awaiting liver transplantation. All three patients were percutaneously injected with HCA to prevent late-onset bleeding. After HCA was discontinued, coagulation was restored to > 60 mg/dL on day 6, without injection of fibrinogen. HCA significantly reduced the need for fibrinogen in patients with hepatic diseases, and the level of fibrinogen should be carefully monitored in clinical applications.
血凝酶常用于出血性疾病患者的止血以及避免或止住手术后的出血。在此，2018年9月期间，北京大学人民医院对3例患有肝病且伴有低纤维蛋白原血症的患者使用了蕲蛇酶血凝酶（HCA）进行治疗。这3例患者均为慢性乙型肝炎患者：患者1患有肝癌和慢性乙型肝炎，接受了右半肝切除术；患者2患有慢性乙型肝炎和胃肠道出血；患者3患有慢性乙型肝炎、急性肝衰竭伴呕血，正在等待肝移植。所有3例患者均经皮注射HCA以预防迟发性出血。停用HCA后，在未注射纤维蛋白原的情况下，第6天时凝血恢复至>60mg/dL。HCA显著减少了肝病患者对纤维蛋白原的需求，临床应用中应仔细监测纤维蛋白原水平。
