Effectiveness of haemocoagulase agkistrodon <i>versus</i> tranexamic acid and sodium chloride in the prevention and treatment of perioperative bleeding: a real-world study_Chinese Journal of Evidence-Based Medicine

Authors：

LV Jinjin ,  XUAN Jianwei

Health Economic Research Institute, School of Pharmaceutical Sciences, SunYat-sen University, Guangzhou 510006, P. R. China;

Corresponding?author：

XUAN Jianwei, Email: xuanjw3@mail.sysu.edu.cn

Keywords：

Real world study; Propensity score matching; Haemocoagulase agkistrodon; Tranexamic acid and sodium chloride; Perioperative bleeding; Effectiveness

DOI：

10.7507/1672-2531.202209102

Video：

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Objective To compare the effectiveness of haemocoagulase agkistrodon and tranexamic acid and sodium chloride in the prevention and treatment of perioperative bleeding in a real world setting. Methods A research database was constructed based on the records of inpatient visits using haemocoagulase agkistrodon and tranexamic acid and sodium chloride according to the SuValue? database from January 1, 2016 to December 31, 2020. The patients were divided into two groups according to the different interventions. After matching with a 1∶1 propensity score, the effectiveness of two groups was compared. Results A total of 858 patients were included in each of the two groups, and there was no statistically significant difference in baseline characteristics between the two groups (P>0.05). Research results showed that patients using haemocoagulase agkistrodon had significantly reduced length of hospital stay, decrease in hematocrit, average estimated surgical bleeding, and decrease in hemoglobin (P<0.01). Conclusion Haemocoagulase agkistrodon has better effectiveness than tranexamic acid and sodium chloride for reducing perioperative blood loss based on current real world evidence.

Citation： LV Jinjin, XUAN Jianwei. Effectiveness of haemocoagulase agkistrodon versus tranexamic acid and sodium chloride in the prevention and treatment of perioperative bleeding: a real-world study. Chinese Journal of Evidence-Based Medicine, 2023, 23(5): 513-516. doi: 10.7507/1672-2531.202209102 Copy

1.	吳嘵嘵, 張慧敏, 荀林娟, 等. 外科手術患者術后出血現況及危險因素研究. 中華現代護理雜志, 2018, 24(27): 3252-3258.
2.	周宗科, 翁習生, 孫天勝, 等. 中國骨科手術加速康復—圍術期血液管理專家共識. 中華骨與關節外科雜志, 2017, 10(1): 1-7.
3.	劉立柱, 宋世鋒, 張偉. 不同預防方案對初次單側膝關節置換患者圍術期失血量影響的比較. 醫學綜述, 2016, 22(21): 4345-4347.
4.	Borghi B, Borghi R. Blood-saving techniques. Transplant Proc, 2011, 43(1): 333-337.
5.	Koh MB, Hunt BJ. The management of perioperative bleeding. Blood Rev, 2003, 17(3): 179-185.
6.	Kozek-Langenecker SA, Afshari A, Albaladejo P, et al. Management of severe perioperative bleeding: guidelines from the European society of anaesthesiology. Eur J Anaesthesiol, 2013, 30(6): 270-382.
7.	王陶然, 高嘉鍇, 畢龍, 等. 聯合使用氨甲環酸在減少肱骨骨折內固定圍術期失血中的作用. 創傷外科雜志, 2021, 23(11): 823-827.
8.	熊利澤. 圍術期出凝血管理麻醉專家共識. 中華麻醉學雜志, 2020, 40(9): 1042-1053.
9.	Ramirez RJ, Spinella PC, Bochicchio GV. Tranexamic acid update in trauma. Crit Care Clin, 2017, 33(1): 85-99.
10.	呂慧敏, 李長齡, 董金嬋, 等. 尖吻蝮蛇凝血酶的止血作用及其作用機制的研究. 中國實驗血液學雜志, 2008, 16(4): 883-885.
11.	郝永玉, 張雪松, 楊全中. 注射用尖吻蝮蛇血凝酶在單節段腰椎PLIF手術中應用的安全性和有效性觀察. 當代醫學, 2020, 26(11): 40-43.
12.	呂驊, 朱明煒, 許靜涌, 等. 尖吻蝮蛇血凝酶對甲狀腺手術創面的止血作用研究. 中華普通外科雜志, 2014, 29(5): 362-365.
13.	許靜涌, 朱明煒, 江華, 等. 注射用尖吻蝮蛇血凝酶用于手術止血的安全性及有效性的系統評價和Meta分析. 中華普通外科雜志, 2015, 30(4): 308-311.
14.	Wei J, Zhu M, Zhang Z, et al. A multicenter, phase Ⅲ trial of hemocoagulase Agkistrodon: hemostasis, coagulation, and safety in patients undergoing abdominal surgery. Chin Med J, 2010, 123(5): 589-593.
15.	莫小汕, 滕居贊. 股骨粗隆間骨折鋼板內固定術使用氨甲環酸止血的效果觀察. 醫藥前沿, 2020, 10(32): 116-117.
16.	田玉科. 圍術期輸血指南. 中國繼續醫學教育, 2011, 3(10): 124-128.
17.	李曉霞, 張蘭, 劉進. 不同相對離心力條件下紅細胞壓積測定結果相關性的研究. 中國輸血雜志, 2005, 18(2): 121-123.
18.	Gao F, Li Z, Zhang K, et al. Four methods for calculating blood-loss after total knee arthroplasty. Chin Med J, 2015, 128(21): 2856-2860.
19.	袁宇飛, 江仲超, 任志鑫, 等. 多劑量靜脈聯合局部應用氨甲環酸對初次全膝關節置換術止血效果的臨床研究. 科學技術與工程, 2021, 21(5): 1730-1734.
20.	魏京霞. 尖吻蝮蛇血凝酶與氨甲環酸術中止血效果比較. 現代臨床醫學, 2013, 39(1): 16-17.
21.	雷翠蓉. 尖吻蝮蛇血凝酶用于子宮頸環形電切術治療宮頸疾病止血效果觀察. 中國藥業, 2014, 23(5): 81-82.
22.	崔璨, 高化, 陳文韜, 等. 氨甲環酸與尖吻蝮蛇血凝酶對老年股骨轉子間骨折內固定手術止血效果比較. 醫藥導報, 2021, 40(9): 1228-1231.
23.	Ghadimi K, Levy JH, Welsby IJ. Perioperative management of the bleeding patient. Br J Anaesth, 2016, 117(suppl 3): iii18-iii30.
24.	Devereaux PJ, Marcucci M, Painter TW, et al. Tranexamic acid in patients undergoing noncardiac surgery. N Engl J Med, 2022, 386(21): 1986-1997.
25.	Colomina MJ, Contreras L, Guilabert P, et al. Clinical use of tranexamic acid: evidences and controversies. Braz J Anesthesiol, 2022, 72(6): 795-812.
26.	王鴻利, 張利偉, 丁秋蘭, 等. 原發性纖溶癥的診斷和鑒別診斷. 實驗與檢驗醫學, 2008, 26(1): 2-4, 91.
27.	Murao S, Nakata H, Roberts I, et al. Effect of tranexamic acid on thrombotic events and seizures in bleeding patients: a systematic review and meta-analysis. Crit Care, 2021, 25(1): 380.
28.	趙陽, 楊東輝, 馬曉霞. 蘇靈注射液與邦亭注射液對結直腸癌術后止血療效的比較. 實用藥物與臨床, 2015, 18(5): 617-619.
29.	夏樾, 楊嗣星, 錢輝軍, 等. 尖吻蝮蛇血凝酶在后腹腔腹腔鏡手術圍手術期應用的有效性與安全性評價. 醫藥導報, 2012, 31(10): 1321-1324.
30.	姚翀, 郭代紅, 王辰允, 等. 32203例注射用尖吻蝮蛇血凝酶相關變態反應自動監測研究. 中國臨床藥理學雜志, 2020, 36(3): 346-350.

1. 吳嘵嘵, 張慧敏, 荀林娟, 等. 外科手術患者術后出血現況及危險因素研究. 中華現代護理雜志, 2018, 24(27): 3252-3258.
2. 周宗科, 翁習生, 孫天勝, 等. 中國骨科手術加速康復—圍術期血液管理專家共識. 中華骨與關節外科雜志, 2017, 10(1): 1-7.
3. 劉立柱, 宋世鋒, 張偉. 不同預防方案對初次單側膝關節置換患者圍術期失血量影響的比較. 醫學綜述, 2016, 22(21): 4345-4347.
4. Borghi B, Borghi R. Blood-saving techniques. Transplant Proc, 2011, 43(1): 333-337.
5. Koh MB, Hunt BJ. The management of perioperative bleeding. Blood Rev, 2003, 17(3): 179-185.
6. Kozek-Langenecker SA, Afshari A, Albaladejo P, et al. Management of severe perioperative bleeding: guidelines from the European society of anaesthesiology. Eur J Anaesthesiol, 2013, 30(6): 270-382.
7. 王陶然, 高嘉鍇, 畢龍, 等. 聯合使用氨甲環酸在減少肱骨骨折內固定圍術期失血中的作用. 創傷外科雜志, 2021, 23(11): 823-827.
8. 熊利澤. 圍術期出凝血管理麻醉專家共識. 中華麻醉學雜志, 2020, 40(9): 1042-1053.
9. Ramirez RJ, Spinella PC, Bochicchio GV. Tranexamic acid update in trauma. Crit Care Clin, 2017, 33(1): 85-99.
10. 呂慧敏, 李長齡, 董金嬋, 等. 尖吻蝮蛇凝血酶的止血作用及其作用機制的研究. 中國實驗血液學雜志, 2008, 16(4): 883-885.
11. 郝永玉, 張雪松, 楊全中. 注射用尖吻蝮蛇血凝酶在單節段腰椎PLIF手術中應用的安全性和有效性觀察. 當代醫學, 2020, 26(11): 40-43.
12. 呂驊, 朱明煒, 許靜涌, 等. 尖吻蝮蛇血凝酶對甲狀腺手術創面的止血作用研究. 中華普通外科雜志, 2014, 29(5): 362-365.
13. 許靜涌, 朱明煒, 江華, 等. 注射用尖吻蝮蛇血凝酶用于手術止血的安全性及有效性的系統評價和Meta分析. 中華普通外科雜志, 2015, 30(4): 308-311.
14. Wei J, Zhu M, Zhang Z, et al. A multicenter, phase Ⅲ trial of hemocoagulase Agkistrodon: hemostasis, coagulation, and safety in patients undergoing abdominal surgery. Chin Med J, 2010, 123(5): 589-593.
15. 莫小汕, 滕居贊. 股骨粗隆間骨折鋼板內固定術使用氨甲環酸止血的效果觀察. 醫藥前沿, 2020, 10(32): 116-117.
16. 田玉科. 圍術期輸血指南. 中國繼續醫學教育, 2011, 3(10): 124-128.
17. 李曉霞, 張蘭, 劉進. 不同相對離心力條件下紅細胞壓積測定結果相關性的研究. 中國輸血雜志, 2005, 18(2): 121-123.
18. Gao F, Li Z, Zhang K, et al. Four methods for calculating blood-loss after total knee arthroplasty. Chin Med J, 2015, 128(21): 2856-2860.
19. 袁宇飛, 江仲超, 任志鑫, 等. 多劑量靜脈聯合局部應用氨甲環酸對初次全膝關節置換術止血效果的臨床研究. 科學技術與工程, 2021, 21(5): 1730-1734.
20. 魏京霞. 尖吻蝮蛇血凝酶與氨甲環酸術中止血效果比較. 現代臨床醫學, 2013, 39(1): 16-17.
21. 雷翠蓉. 尖吻蝮蛇血凝酶用于子宮頸環形電切術治療宮頸疾病止血效果觀察. 中國藥業, 2014, 23(5): 81-82.
22. 崔璨, 高化, 陳文韜, 等. 氨甲環酸與尖吻蝮蛇血凝酶對老年股骨轉子間骨折內固定手術止血效果比較. 醫藥導報, 2021, 40(9): 1228-1231.
23. Ghadimi K, Levy JH, Welsby IJ. Perioperative management of the bleeding patient. Br J Anaesth, 2016, 117(suppl 3): iii18-iii30.
24. Devereaux PJ, Marcucci M, Painter TW, et al. Tranexamic acid in patients undergoing noncardiac surgery. N Engl J Med, 2022, 386(21): 1986-1997.
25. Colomina MJ, Contreras L, Guilabert P, et al. Clinical use of tranexamic acid: evidences and controversies. Braz J Anesthesiol, 2022, 72(6): 795-812.
26. 王鴻利, 張利偉, 丁秋蘭, 等. 原發性纖溶癥的診斷和鑒別診斷. 實驗與檢驗醫學, 2008, 26(1): 2-4, 91.
27. Murao S, Nakata H, Roberts I, et al. Effect of tranexamic acid on thrombotic events and seizures in bleeding patients: a systematic review and meta-analysis. Crit Care, 2021, 25(1): 380.
28. 趙陽, 楊東輝, 馬曉霞. 蘇靈注射液與邦亭注射液對結直腸癌術后止血療效的比較. 實用藥物與臨床, 2015, 18(5): 617-619.
29. 夏樾, 楊嗣星, 錢輝軍, 等. 尖吻蝮蛇血凝酶在后腹腔腹腔鏡手術圍手術期應用的有效性與安全性評價. 醫藥導報, 2012, 31(10): 1321-1324.
30. 姚翀, 郭代紅, 王辰允, 等. 32203例注射用尖吻蝮蛇血凝酶相關變態反應自動監測研究. 中國臨床藥理學雜志, 2020, 36(3): 346-350.

Chinese Journal of Evidence-Based Medicine

Effectiveness of haemocoagulase agkistrodon versus tranexamic acid and sodium chloride in the prevention and treatment of perioperative bleeding: a real-world study

Abstract Full text Figures/Tables Video References Cited by

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