Delaruelle J, Marquet J
Arch Otorhinolaryngol. 1977 Jun 30;217(1):87-92. doi: 10.1007/BF00453894.
In 398 cases of observed capillary bleeding out of total of 968 otological microsurgeries, the i.v. use of Bothrops Jararaca enzyme proved to be highly useful in controlling the bleeding in 79% of those, namely in 318 cases. We may assume that if capillary bleeding is indeed the consequence of some haemostatic deficiency, not always detectable with the routine laboratory preoperative tests, Bothrops Jararaca enzyme is extremely valuable in controlling this bleeding. If however oozing or capillary bleeding is the result of other circumstances, such as insufficient analgesia and neurolepsia, inadequate anaesthetic technique, wrong positioning of the head resulting in venous congestion of the operative region, or local fibrinolysis due to protracted microsurgery, other measures should be taken to correct these conditions which are not due to coagulation defects. Bothrops Jararaca enzyme, given by i.v. route, even in single dose of 2-6 units = 2-6 ampoules, was perfectly tolerated by all the patients without any side effect or allergic manifestations.
在968例耳科显微手术中，观察到398例出现毛细血管出血，静脉注射矛头蝮蛇毒酶被证明对其中79%（即318例）的出血控制非常有效。我们可以假设，如果毛细血管出血确实是某种止血缺陷的结果，而这种缺陷并非总是能通过术前常规实验室检查检测出来，那么矛头蝮蛇毒酶在控制这种出血方面极具价值。然而，如果渗血或毛细血管出血是由其他情况导致的，比如镇痛和神经安定不足、麻醉技术不当、头部位置错误导致手术区域静脉充血，或者由于长时间显微手术引起局部纤维蛋白溶解，那么就应该采取其他措施来纠正这些并非由凝血缺陷引起的情况。通过静脉途径给予矛头蝮蛇毒酶，即使单剂量为2 - 6单位（即2 - 6支安瓿），所有患者都能完全耐受，没有任何副作用或过敏表现。
