摘要
目的分析白眉蛇毒血凝酶对肺结核并咯血患者凝血功能的影响及其治疗效果。方法选择2016年1月至2018年9月医院收治的肺结核合并咯血患者76例,随机分为对照组及观察组,每组38例。对照组使用氨甲苯酸、去甲肾上腺素等止血治疗,观察组在此基础上加用白眉蛇毒血凝酶。在入院时和治疗48 h后,检测患者凝血功能,比较两组咯血停止时间及咯血量。治疗中,观察两组不良反应。结果观察组咯血止血时间短于对照组,且咯血量低于对照组(P<0.05)。治疗48 h后,观察组纤维蛋白原低于治疗前,且低于同一时间点对照组(P<0.05)。观察组总有效率(94.74%)高于对照组(73.68%,P<0.05)。观察组出现4例继发性凝血功能障碍,其凝血酶原时间及纤维蛋白原低于危急值。结论白眉蛇毒血凝酶对肺结核合并咯血疗效肯定,但可能会诱发继发性凝血功能障碍,延迟凝血酶原时间并降低纤维蛋白原,需要给予足够的重视。临床上应把握适应证,控制使用剂量,用药后加强凝血功能监控。
Objective To analyze the effect of hemocoagulase from Baimei snake venom on the coagulation function of patients with pulmonary tuberculosis and hemoptysis,and to analyze the therapeutic effect.Methods A total of 76 patients with pulmonary tuberculosis and hemoptysis admitted to the hospital from January 2016 to September 2018 were randomly divided into control group and observation group and 38 cases in each group.The control group was treated with aminomethylbenzoic acid and norepinephrine,and the observation group was treated with hemagglutinase.At the time of admission and 48 hours after treatment,the coagulation function of the patients was measured,and the stop time and hemoptysis volume of the two groups were compared.And 48 hours after treatment,the therapeutic effect was evaluated.Results After 48 hours,the fibrinogen in the observation group was lower than that before treatment,and the fibrinogen in the comparison observation group was lower than that in the control group(P<0.05).The stop time and volume of hemoptysis in the observation group were lower than those in the control group(P<0.05).In the observation group,there were 4 cases of secondary coagulation dysfunction,prothrombin time and fibrinogen were lower than the critical value.The therapeutic effect of the observation group was better than that of the control group(P<0.05).Conclusion Hemagglutinin from Baimei snake venom has a positive effect on pulmonary tuberculosis and hemoptysis,but it may induce secondary coagulation dysfunction,delay thrombin time and reduce fibrinogen.We need to pay enough attention to the indications,control the dosage,and strengthen the monitoring of coagulation function.
作者
易江
程阔菊
YI Jiang;CHENG Kuo-ju(Department of Infections,Xuanhan People's Hospital,Xuanhan 636150,Sichuan Province,China;Department of Pharmacy,Dazhou Integrated Traditional Chinese Medicine and Western Medicine Hospital,Dazhou 635000,Sichuan Province,China)
出处
《世界临床药物》
CAS
2020年第3期199-202,219,共5页
World Clinical Drug
基金
达州市科技计划项目(201501)。
关键词
肺结核
咯血
凝血功能
蛇毒血凝酶
tuberculosis
hemoptysis
coagulation function
snake venom hemagglutinase
