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Local application of general surgery to stop bleeding effect of thrombin


-4U / h, beginning 42 hours after surgery, three hours bleeding 300ml, then surgery to stop bleeding and then double-check that the infusion of vasopressin arm venous leak. Arm swelling, but failed to play the role of intraoperative bleeding, see a more harmful at the gallbladder bed purple blood clots, close adhesion, the surface slowly oozing. D Yuan stay to see the town of cowpea Medical College by 1998 . . A Since 1992, we used thrombin digestion and ulcer bleeding sacrifice made satisfactory outcome of 60 down, now results are summarized as follows. l Materials and Methods I. I clinical cases are selected from the flea abundance + hospital, endoscopy, upper gastrointestinal bleeding associated with peptic ulcer confirmed through a total of 116 patients were randomly divided into two groups, treatment group 52 males and 8 females; age of l6-52 years, mean 42 years: 26 cases in which gastric ulcer, duodenal ulcer 34 cases, massive bleeding in 20 cases, 40 cases of moderate bleeding, 56 patients in the control knob of gI, age, amount of bleeding and other bleeding sites with comparable aspects treatment of the treatment group I_2 2000 smart with thrombin dissolved in 30ml saline Ⅱ 113, every 4 hours t times,[link widoczny dla zalogowanych], the control group spent norepinephrine cable 2ml ~ fl oral saline 30al, 1 change every 4 hours. During the course of treatment was observed without other hemostatic blood pressure pulse, hemoglobin, liver function, kidney function. Fecal occult blood test and whether the incidence of adverse bleeding according to the endoscopic disappearance of fecal occult blood stool to yellow or negative for any of the three to determine the bleeding to stop the bleeding was 48th when the technology within 72 hours of a 96 / J, when hemostasis is effective. Hemostatic effect and to compare the two groups for statistical analysis asked whether there were significant differences in the results of r2 thrombin and hemostatic effects of norepinephrine scribe: 484, when significant efficiency within the hemostatic thrombin was 76.68%, to A 'adrenal tangled to 46.16%: 72h 96h in a total effective rate of bleeding was 92% of thrombin, norepinephrine cable is 61.56% so the efficiency of thrombin hemostasis and total effective rate was significantly better than norepinephrine scribe (P <O .05) 'side effects: treatment of Wen norepinephrine in the cable group 56 fed 6 cases S75. {PC / significant gastrointestinal reactions I thrombin group, 60 cases of patients without obvious side effects. Hematuria in all cases during the treatment practices and changes in liver and kidney function were normal 3 to discuss the current number of drug treatment of peptic ulcer bleeding; more effective with posterior pituitary Li, Li and other norepinephrine. These are connected from the gate of the hemostatic effects. Side effects of contraction of vascular drugs more especially the posterior lobe of the pituitary gland cable staggering, and have some contraindication to promote blood clotting process commonly used drug to stop bleeding and Min Fang acid antifibrinolytic effect is not ideal, many drugs associated with the bleeding use, excessive thrombus formation has caused most of these drugs need to be considered intravenous administration, bleeding time, thrombin longer widely used in recent years in China have difficulty ligation of small vessels, capillaries and Visceral bleeding, it has exactly rapid hemostasis. We use oral thrombin on bleeding peptic ulcer, the effect is ideal. When thrombin after oral administration, can be directly on the bleeding vessel locally, so that fibrinogen into fibrin, leading to rapid blood coagulation, j induced into blood clots. Thrombin also can promote platelet aggregation and irreversible platelet release reaction, accelerated blood clotting and promote bleeding vessel localized epithelial cell growth, accelerating wound healing, played good hemostatic effect observed in this group data show that thrombin treatment of peptic effective rate of ulcer bleeding 92%, and norepinephrine J II cable glands compared to the efficiency and total effective rate was significantly better than the control thrombin group, P <O. 05 compared to cable and norepinephrine, oral thrombin easy to use, the role of rapid, effective rate, no side effects to save the patient's life provides some protection to those of us in particular is more applicable to primary health care units, is worthy of clinical (Received :1997-1120】 Head of significant bleeding, coagulation invalid Park omental adhesions in the surgical incision appendectomy, to move from oppression to the role, so the conservative treatment failed to stop the bleeding after the omental free will out cavity in the sponge and bleeding profile 25oou thrombin patching, suturing the omentum to stop bleeding in patients discharged from hospital was more profound lesson in this case, for the poor liver function, coagulation dysfunction, and they should hemostasis, and the need to add pressure in order to play good results with thrombin 2.3 units of thrombin is an effective body of local hemostatic exact, in the future work will pay attention to lessons learned in order to better play the role of thrombin in the bleeding patient services