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妇科手术过程中应用立止血后的凝血因子与血小板(作者译)

[Coagulation factors and thrombocytes after application of Reptilase in the course of gynecologic operations (author's transl)].

作者信息

Cornely M, Barthels M, Henkel E

出版信息

Med Klin. 1978 May 19;73(20):760-4.

PMID:651762
Abstract

Hemostasiologic effects of intravenous application of Reptilase were investigated in a randomized double blind study in the course of normal abdominal and vaginal hysterectomies. Coagulation factors and thrombocytes were checked before, after, 40 minutes after as well as 24 hours after the operation. Significant shortening of the clot observation time resulted 40 minutes after the injection of 1 ml Reptilase. A small but highly significant decrease of thrombocytes was observed 40 minutes after the end of the operation when Reptilase was injected. Further coagulation screening tests: Quick test, PTT and thrombin time were without statistically differences in both patients groups from the beginning till 24 hours after the operation. A significant decrease in Factor V concentrations resulted 40 minutes after the injection of Reptilase, whereas no changes were seen in the placebo patient group. Too, Factor XIII values and Antithrombin 3 concentrations decreased after the administration of Reptilase. There was no abnormal raise of fibrin-monomers in both groups. Enhanced fibrinolysis with elevated FDP-levels were measured in none of the cases. The administration of Reptilase induced a short lasting augmentation of blood coagulation but without any signs of disseminated intravascular coagulation.

摘要

在正常腹部及阴道子宫切除术过程中,通过一项随机双盲研究,对静脉注射立止血的止血效果进行了调查。在手术前、后、术后40分钟以及术后24小时检查凝血因子和血小板。注射1毫升立止血40分钟后,凝血观察时间显著缩短。当注射立止血时,术后40分钟观察到血小板有轻微但高度显著的减少。进一步的凝血筛查试验:Quick试验、部分凝血活酶时间(PTT)和凝血酶时间,从手术开始至术后24小时,两组患者均无统计学差异。注射立止血40分钟后,因子V浓度显著降低,而安慰剂组患者未见变化。同样,注射立止血后,因子XIII值和抗凝血酶3浓度降低。两组均无纤维蛋白单体异常升高。所有病例均未检测到纤维蛋白降解产物(FDP)水平升高导致的纤维蛋白溶解增强。立止血的给药引起了凝血的短暂增强,但没有任何弥散性血管内凝血的迹象。

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