摘要
目的 用血栓弹力图评价开胸手术围术期凝血纤溶功能的变化。方法 选择开胸手术患者40例,分别于术前、术中3h、术后第1天、术后第3天采集中心静脉血液标本,检测凝血四项指标和血栓弹力描记图(TEG)。结果 围术期PT、APTT无显著性差异,FG含量术后第1天和第3天显著低于术前和术中(P <0 0 5 )。TEG显示术中、术后反应时间(R)值和K值均逐渐增加,但与术前相比无显著性差异(P >0 0 5 ) ;最大振幅(MA)在术中3h和术后第1天降低,但与术前和术后第3天相比无显著性差异(P >0 0 5 ) ;凝血指数(CI)术中与术前相比降低,有显著性差异(P <0 0 5 ) ,术后继续降低,但与术中相比无显著性差异;MA后3 0min内血凝块幅度减少的速率(LY3 0 )术后第1天开始增加,与术前和术中相比具有非常显著的差异(P <0 0 1)。结论 开胸手术病人术中、术后凝血状态趋于低凝,TEG可对开胸手术围术期凝血纤溶功能的变化提供全面而准确的监测。
Objective To assess the changes of coagulation and fibinolysis in patients undergoing thoracotomy. Methods Forty patients undergoing thoracotomy were enrolled into this trial. The venous blood were collected for normal coagulable function test at the following time points: before surgery, at 3 h after the beginning of surgery, at 1 d and 3 d after surgery. Results PT, APTT levels had no obvious change. Compared with before and during surgery, FG levels decreased obviously at 1 d and 3 d after surgery. TEG showed the value of R and K increased during and after surgery and value of MA decreased during and 1 d after surgery, but they had no significance in statistics. CI decreased significantly during and after surgery as compared with before surgery(P<0.05). LY30 increased significantly after surgery as compared with before and during surgery(P<0.01). Conclusion Coagulability decreased during and after thoracotomy. TEG allowed for overall and correct information about perioperative changes of coagulation and fibrinolysis in patients undergoing thoracotomy.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2005年第7期658-659,共2页
Journal of Third Military Medical University
关键词
血栓弹力图
开胸手术
凝血
纤溶
thromboelastography
thoracotomy
coagulation
fibrinolysis
