The Influence Of Hem Ocoagulase Agkistrodon To The Amount Of Bleeding In The Glioma Excision

Objective:To investigate the influence of hem ocoagulase agkistrodon (HCA) to the amount of bleeding in the glioma excision and its effect and influence of blood conservation during the peri operative period.Methods:A total number of sixty ASA Ⅰ-Ⅱ patients,male thirty-five,female twenty-five,aged20-60year,weight45-70kg undergoing glioma excision were randomly divided into two groups:group A is hem ocoagulase agkistrodon (HCA) group;group B is control group.All of the patients intramuscular inject midazolam2mg and penehyclidine hydrochloride0.5mg On the30minutes before the operation. After entering the operating room, we minitored the mean arterial pressure (MAP), pulse oxygensaturation (SpO2), electrocardiogram (ECG). The induction of general anesthesia adopt midazolam0.1mg/kg, propofol lmg/kg, fentanyl4μg/kg, atracurium0.7mg/kg and we began to endotracheal intubation then mechanical ventilate using anaesthesia machine.Maintenance of general anesthesia adopt fentanyl1-2μg/kg, atracurium0.2-0.3mg/kg,Isoflurane1-2%.After the induction,we did the central vein chcheterization and minitored the central venous pressure(CVP) through patient monitor;we did foot back arteriopuncture ane minitored the invasive blood pressure(IBP) through patient monitor。Before fixing the surgical headstock,we gave fentanyl0.1mg.Before skin incision,we gave fentanyl0.2mg. On the30minutes before skin incision,we intravenous inject0.9%normal saline10ml adding heamocoagulase agkistrodon injection0.4U/kg in group A and we intravenous inject0.9%normal saline10ml in group B.We drew blood to examine hemoglobin(Hb),hematokrit(Hct),white blood cell(WBC),platelet(Plt),prothrombin time(PT),the activated partial thromboplastin time(APTT),the content of fibrinogen(FIB) at the preoperation and postoperation.We record the blood lost in operation,the incision lead flow during24hours after operation,the infusion of red blood cell suspension in operation and the untoward effect(anaphylactic reaction,renal dysfunction and so on.Results:1. Sex ratio、age、weight、ASA classification surgery category have no significant difference between two groups(P>0.05).2. In group A, the blood lost in operation,the incision lead flow during24hours after operation and the infusion of red blood cell suspension in operation is also less than these in group B(P<0.05).3. Compared with preoperation,the hemoglobin (Hb) and hematokrit (HCT) Significantly reduced(P<0.05), but white blood cell (WBC) sharply increased (P<0.05) at postoperation. The platelet (PLT) at each time have no significant difference between two groups and among these groups(P>0.05).4. The prothrombin time (PT), the activated partial thromboplastin time (APTT), the content of fibrinogen (FIB) at each time have no significant difference between two groups and among these groups(P>0.05).Conclusion:Hem ocoagulase agkistrodon (HCA) apply to craniotomy of glioma excision, it can obviously reduce the the amount of bleeding lost in operation, the incision lead flow during24hours after operation and the infusion of red blood cell suspension in operation. Furthermore, it have no clear effect on the autologous coagulation function and platelet function. It also can obviously reduce a series of complication following blood transfusion and then gain the end of blood conservation.