注射用蛇毒血凝酶在消化内镜治疗消化性溃疡出血中的 应用价值

张迷春，李龙

咸阳市中心医院，陕西 咸阳，712000

浏览次数：155次 下载次数：395次

摘要：

目的 探讨注射用蛇毒血凝酶在消化内镜治疗消化性溃疡出血中的应用价值。方法 将本院收治的消化性溃疡出血患者 94例以便利抽样法分为常规组和治疗组，各 47例。常规组采用消化内镜电凝或钛夹止血，治疗组在此基础上在消化内镜下注射蛇毒血凝酶，比较两组治疗效果。结果 两组患者的即时止血成功率差异不显著（P>0.05），治疗组 7 d后止血成功率、中转手术率优于常规组（P<0.05）。两组治疗前、后的 PTA、PT、Fib、PLT 水平差异无统计学意义（P>0.05）。结论 在消化内镜治疗消化性溃疡出血时加用蛇毒血凝酶可提高止血成功率，减少患者中转手术率，且对凝血功能无影响。

关键词： 蛇毒血凝酶；消化内镜；消化性溃疡出血

中图分类号：R573.1文献标志码：A文章编号：2096-1413(2018)07-0018-02

Application value of snake venom blood coagulation enzyme in the digestive
endoscopy treatment of pepticulcer bleeding

ZHANG Mi-chun,LILong *
(Xianyang Central Hospital, Xianyang 712000, China)



ABSTRACT: Objective To explore the value of snake venom blood coagulation enzyme in the digestive endoscopy treat-ment of peptic ulcer bleeding. Methods A total of 94 patients with peptic ulcer bleeding were divided into routine group and treatment group with convenients ampling method,with 47 cases in each group.The routine group was treated with en-doscopic coagulation ortitanium clip,on thisbasis,the treatment group was given digestive endoscopic injection of snake venom blood coagulation enzyme.The clinical effects were compared between the two groups. ResultsThere was no significant difference between the two groups in the immediate success rate of hemostasis (P>0.05).The success rate of hemostasisafter 7d,rate of transits urgery in the treatment group were superior to those in the routine group (P<0.05).There were no significant differences in the levels of PTA, PT,Fib and PLT between the two groups before and after treatment (P>0.05). Conclusion Venom blood clotting enzyme used in the digestive endoscopic treatment of peptic ulcer bleeding can improve the success rate of hemostasis,reduce the rate of transits urgery, with no effect on the coagulation function.                                                                                                                                 KEYWORDS: snakevenom blood coagulation enzyme; digestive endoscopy; pepticulcer bleeding

参考文献：
[1] 贺继东 , 王莉 . 白眉蛇毒血凝酶与巴西矛头蝮蛇毒血凝酶治疗消化性溃疡致出血的疗效比较 [J]. 实用临床医药杂志 ,2014,18(21):192-193.
[2] 黄贵华 , 陈国忠 . 消化内科中西医结合诊疗手册 [M]. 北京 : 化学工业出版社 ,2015.
[3] 付强 . 消化性溃疡出血患者进行内镜下 Forrest 分级的临床意义[J]. 世界最新医学信息文摘 : 电子版 ,2017,17(9):74.
[4] 李雷 , 史佳 . 注射用血凝酶联合兰索拉唑治疗老年消化道溃疡伴出血的临床分析 [J]. 中华全科医学 ,2015,13(3):410-412.
[5] 符益 , 朱材忠 , 吴素江 , 等 . 奥美拉唑联合蛇毒血凝酶治疗消化道溃疡大出血的临床疗效研究 [J]. 山西医药杂志 ,2017,46(8):923-925.
[6] 严明科 , 鲍磊 , 王迎新 , 等 . 白眉蛇毒血凝酶联合泮托拉唑在上消化道出血患者中的作用机制研究 [J]. 海南医学院学报 ,2017,23(3):345-348.
[7] 周青梅 , 付晓林 , 乔强 . 蛇毒血凝酶及云南白药对非静脉曲张上消化道出血治疗效果及并发症的影响 [J]. 中国中西医结合消化杂志 ,2016,24(8):620-622.
[8] 綦天红 . 血凝酶联合兰索拉唑治疗上消化道出血的临床观察 [J].中国冶金工业医学杂志 ,2016,33(4):436-437.