首页|注射用白眉蛇毒血凝酶对外科手术切口止血疗效和安全性的Meta分析

注射用白眉蛇毒血凝酶对外科手术切口止血疗效和安全性的Meta分析

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目的 探讨注射用白眉蛇毒血凝酶对外科手术切口止血的有效性和安全性。方法 计算机检索万方、VIP、CNKI,收集白眉蛇毒血凝酶在外科手术切口中止血的随机对照试验(RCT),检索时间为建库至 2023 年 12 月 1 日。采用RevMan 5。4 软件进行Meta分析。结果 共纳入 13 项RCT,共 1 027 例患者。Meta分析结果显示,白眉蛇毒血凝酶组的平均止血时间、单位面积出血量、术中出血量和术后第 1 天的凝血酶时间(TT)均小于对照组(P<0。05);活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)及纤维蛋白原(FIB)含量方面,两组差异无统计学意义(P>0。05)。亚组分析显示,不同类型的手术切口中,白眉蛇毒血凝酶组的止血时间、单位面积的出血量及术中出血量均减少(P<0。05)。神经外科手术切口术后第 1 天白眉蛇毒血凝酶组PT大于对照组(P<0。05),两组TT、APTT、FIB差异无统计学意义(P>0。05);鼻内镜手术、普通外科手术切口术后第 1 天两组TT、APTT、PT、FIB差异均无统计学意义(P>0。05);妇科手术切口术后第 1 天白眉蛇毒血凝酶组TT、PT低于对照组(P<0。05),两组APTT、FIB差异无统计学意义(P>0。05)。共有 6 项研究对白眉蛇毒血凝酶使用后的不良反应进行报道,其中 4 项研究并未观察到任何不良反应。结论 与对照组相比,白眉蛇毒血凝酶对外科手术切口的止血疗效更佳,且对患者凝血功能影响较小,未增加不良反应事件的发生,安全性较好。
Efficacy and safety of white-browed snake venom hemocoagulase for injection in surgical tresis vulnus:a Meta-analysis
Objective To evaluate the efficacy and safety of white-browed venom hemocoagulase for injection in surgical tresis vulnus.Methods Wanfang,VIP,and CNKI were computerized searched to collect randomized controlled trials(RCTs)of white-browed snake venom thrombin for hemostasis in surgical incisions from the construction of databases to December 1,2023.Meta-analysis was performed using RevMan 5.4 software.Results A total of 13 RCTs with 1 027 patients were included.Meta-analysis showed that the mean hemostasis time,bleeding per unit area,intraoperative bleeding,and thrombin time(TT)on the first postoperative day in the white-browed snake venom hemocoagulase group were smaller than those in the control group(P<0.05);the activated partial thromboplastin time(APTT),prothrombin time(PT),and fibrinogen(FIB)content between the two groups were not statistically significant(P>0.05).Subgroup analysis showed that among different types of surgical incisions,the hemostasis time,bleeding per unit area and intraoperative bleeding were reduced in the white-browed snake venom hemocoagulase group(P<0.05).PT in the white-brow snake venom hemocoagulase group was greater than that in the control group on the first postoperative day of neurosurgical incisions(P<0.05),and the differences in TT,APTT,and FIB between the two groups were not statistically significant(P>0.05);in the first postoperative day of nasal endoscopic surgery and general surgical incisions,there were no statistically significant differences between the two groups in terms of TT,APTT,PT,and FIB(P>0.05);and in the first postoperative day of gynecological incisions,the TT and PT of the white-browed snake venom hemocoagulase group were lower than those of the control group(P<0.05),and the differences in APTT and FIB between the two groups were not statistically significant(P>0.05).A total of six studies reported adverse reactions after the use of white-browed snake venom hemocoagulase,of which four studies did not observe any adverse reactions.Conclusion Compared with the control group,white-browed snake venom hemocoagulase has better hemostatic efficacy for surgical incisions,and has less effect on the coagulation function of patients,without increasing the occurrence of adverse events,and has a better safety profile.

White-browed snake venom hemocoagulaseSurgical incisionThrombin timeActivated partial thromboplastin timeProthrombin timeFibrinogenSafetyMeta-analysis

邵千航、刘雪梅、黄琳、封宇飞

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北京大学人民医院药学部(北京 100044)

白眉蛇毒血凝酶 外科手术切口 凝血酶时间 活化部分凝血活酶时间 凝血酶原时间 纤维蛋白原 安全性 Meta分析

中国药品监督管理研究会立项项目

药监研[2021]043号

2024

中国药师
国家药品监督管理局高级研修学院,武汉医药(集团)股份有限公司

中国药师

CSTPCD
影响因子:0.944
ISSN:1008-049X
年,卷(期):2024.27(5)
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