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.	吴哓哓, 张慧敏, 荀林娟, 等. 外科手术患者术后出血现况及危险因素研究. 中华现代护理杂志, 2018, 24(27): 3252-3258.
2.	周宗科, 翁习生, 孙天胜, 等. 中国骨科手术加速康复—围术期血液管理专家共识. 中华骨与关节外科杂志, 2017, 10(1): 1-7.
3.	刘立柱, 宋世锋, 张伟. 不同预防方案对初次单侧膝关节置换患者围术期失血量影响的比较. 医学综述, 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, 高嘉锴, 毕龙, 等. 联合使用氨甲环酸在减少肱骨骨折内固定围术期失血中的作用. 创伤外科杂志, 2021, 23(11): 823-827.
8.	熊利泽. 围术期出凝血管理麻醉专家共识. 中华麻醉学杂志, 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.	吕慧敏, 李长龄, 董金婵, 等. 尖吻蝮蛇凝血酶的止血作用及其作用机制的研究. 中国实验血液学杂志, 2008, 16(4): 883-885.
11.	郝永玉, 张雪松, 杨全中. 注射用尖吻蝮蛇血凝酶在单节段腰椎PLIF手术中应用的安全性和有效性观察. 当代医学, 2020, 26(11): 40-43.
12.	吕骅, 朱明炜, 许静涌, 等. 尖吻蝮蛇血凝酶对甲状腺手术创面的止血作用研究. 中华普通外科杂志, 2014, 29(5): 362-365.
13.	许静涌, 朱明炜, 江华, 等. 注射用尖吻蝮蛇血凝酶用于手术止血的安全性及有效性的系统评价和Meta分析. 中华普通外科杂志, 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, 滕居赞. 股骨粗隆间骨折钢板内固定术使用氨甲环酸止血的效果观察. 医药前沿, 2020, 10(32): 116-117.
16.	田玉科. 围术期输血指南. 中国继续医学教育, 2011, 3(10): 124-128.
17.	李晓霞, 张兰, 刘进. 不同相对离心力条件下红细胞压积测定结果相关性的研究. 中国输血杂志, 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.	袁宇飞, 江仲超, 任志鑫, 等. 多剂量静脉联合局部应用氨甲环酸对初次全膝关节置换术止血效果的临床研究. 科学技术与工程, 2021, 21(5): 1730-1734.
20.	魏京霞. 尖吻蝮蛇血凝酶与氨甲环酸术中止血效果比较. 现代临床医学, 2013, 39(1): 16-17.
21.	雷翠蓉. 尖吻蝮蛇血凝酶用于子宫颈环形电切术治疗宫颈疾病止血效果观察. 中国药业, 2014, 23(5): 81-82.
22.	崔璨, 高化, 陈文韬, 等. 氨甲环酸与尖吻蝮蛇血凝酶对老年股骨转子间骨折内固定手术止血效果比较. 医药导报, 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.	王鸿利, 张利伟, 丁秋兰, 等. 原发性纤溶症的诊断和鉴别诊断. 实验与检验医学, 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.	赵阳, 杨东辉, 马晓霞. 苏灵注射液与邦亭注射液对结直肠癌术后止血疗效的比较. 实用药物与临床, 2015, 18(5): 617-619.
29.	夏樾, 杨嗣星, 钱辉军, 等. 尖吻蝮蛇血凝酶在后腹腔腹腔镜手术围手术期应用的有效性与安全性评价. 医药导报, 2012, 31(10): 1321-1324.
30.	姚翀, 郭代红, 王辰允, 等. 32203例注射用尖吻蝮蛇血凝酶相关变态反应自动监测研究. 中国临床药理学杂志, 2020, 36(3): 346-350.

1. 吴哓哓, 张慧敏, 荀林娟, 等. 外科手术患者术后出血现况及危险因素研究. 中华现代护理杂志, 2018, 24(27): 3252-3258.
2. 周宗科, 翁习生, 孙天胜, 等. 中国骨科手术加速康复—围术期血液管理专家共识. 中华骨与关节外科杂志, 2017, 10(1): 1-7.
3. 刘立柱, 宋世锋, 张伟. 不同预防方案对初次单侧膝关节置换患者围术期失血量影响的比较. 医学综述, 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, 高嘉锴, 毕龙, 等. 联合使用氨甲环酸在减少肱骨骨折内固定围术期失血中的作用. 创伤外科杂志, 2021, 23(11): 823-827.
8. 熊利泽. 围术期出凝血管理麻醉专家共识. 中华麻醉学杂志, 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. 吕慧敏, 李长龄, 董金婵, 等. 尖吻蝮蛇凝血酶的止血作用及其作用机制的研究. 中国实验血液学杂志, 2008, 16(4): 883-885.
11. 郝永玉, 张雪松, 杨全中. 注射用尖吻蝮蛇血凝酶在单节段腰椎PLIF手术中应用的安全性和有效性观察. 当代医学, 2020, 26(11): 40-43.
12. 吕骅, 朱明炜, 许静涌, 等. 尖吻蝮蛇血凝酶对甲状腺手术创面的止血作用研究. 中华普通外科杂志, 2014, 29(5): 362-365.
13. 许静涌, 朱明炜, 江华, 等. 注射用尖吻蝮蛇血凝酶用于手术止血的安全性及有效性的系统评价和Meta分析. 中华普通外科杂志, 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, 滕居赞. 股骨粗隆间骨折钢板内固定术使用氨甲环酸止血的效果观察. 医药前沿, 2020, 10(32): 116-117.
16. 田玉科. 围术期输血指南. 中国继续医学教育, 2011, 3(10): 124-128.
17. 李晓霞, 张兰, 刘进. 不同相对离心力条件下红细胞压积测定结果相关性的研究. 中国输血杂志, 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. 袁宇飞, 江仲超, 任志鑫, 等. 多剂量静脉联合局部应用氨甲环酸对初次全膝关节置换术止血效果的临床研究. 科学技术与工程, 2021, 21(5): 1730-1734.
20. 魏京霞. 尖吻蝮蛇血凝酶与氨甲环酸术中止血效果比较. 现代临床医学, 2013, 39(1): 16-17.
21. 雷翠蓉. 尖吻蝮蛇血凝酶用于子宫颈环形电切术治疗宫颈疾病止血效果观察. 中国药业, 2014, 23(5): 81-82.
22. 崔璨, 高化, 陈文韬, 等. 氨甲环酸与尖吻蝮蛇血凝酶对老年股骨转子间骨折内固定手术止血效果比较. 医药导报, 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. 王鸿利, 张利伟, 丁秋兰, 等. 原发性纤溶症的诊断和鉴别诊断. 实验与检验医学, 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. 赵阳, 杨东辉, 马晓霞. 苏灵注射液与邦亭注射液对结直肠癌术后止血疗效的比较. 实用药物与临床, 2015, 18(5): 617-619.
29. 夏樾, 杨嗣星, 钱辉军, 等. 尖吻蝮蛇血凝酶在后腹腔腹腔镜手术围手术期应用的有效性与安全性评价. 医药导报, 2012, 31(10): 1321-1324.
30. 姚翀, 郭代红, 王辰允, 等. 32203例注射用尖吻蝮蛇血凝酶相关变态反应自动监测研究. 中国临床药理学杂志, 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

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