原位肝移植术后监测内、外源性凝血因子和D-二聚体的初步探讨.pdfVIP

，飞r:G-~Chinese General Practice 飞A;il ， 2010年5月第1 捕 SS ,:, ·论著· 原位肝移植术后监测内、外源性凝血因子和 D- 工聚体的 初步探讨 黄顺伟，管向东 {摘察} 目的 探讨原位Jlf移植术后忽者内、外;球性凝血阁子及 D-二聚体变化情况，观察斗之后补充，凝血因子 后的效果。方法 5 例~位肝移植患者手术前后检查凹‘和A凹ì，术后第 1 天抽血分别查肉、外派性凝血因子和D-二 聚体，第 3 天l.j量。呻二聚体。结果 5 例原位肝移植患者手术前后检查 pf 和 A阿T 均无显著变化，内源性凝血阂子 主姿有泊、XIl较正常值降低，外源性凝血阂子主要有 H 、 VI 、 X 较正常他降低，术后第一夭。二来体均升高明巢， 根据结果补充凝成因子后，第三天D-二聚体显著下降，但大部分仍高于正常。结论 原位肝移植患者术后存在内源 性凝血因子洒、础和外源性凝成罔子H 、 vn 、 X 缺乏现象，以外源性凝Ja. 因子缺乏的程Z史最为严囊，补充，缺乏的凝成 园子后第 3 天 D 叩二聚体明显下降，故移植术后除常规观察川和APIT外，还应该根据凝血因子测定来补充凝血因子， 避免发生医源性凝Ju.功能紊乱，凝Ju. 阂子的测定可作为原位肝移梳术后常规检查中积极，而有筑的补充。 [关键词] ~位肝移植;凝血阂子; D-二聚体 i 中固分类号1 R 575 [文献标识码1 A [文章编号1 1007 -9572 (2010) 5S-删l-æ Tbe Primary 胁ldy in Surveillance of Endogenous and Exogenous Coa刷刷刷n Facωrs and D - Dimer after Liver Trans- planta仙n HUANG Shun wei ,GUAN Xiang 呻 dong. Thefirst affiliated hospita.l 01 Sun Yat sun university ,Gtωngzhou 5108∞， Chinα [Abstract] Objectlve To 叫，lore the change of end咿则s and exogenoωcoagulation factors and D - Dimer after or- thotopic liver transplantation (OLT) and outcome after supplementaηcoagulation factor百. Meth创k 币le 8urveillance of PT and APIT in five patients before and after OLT and endogenou5 and exogenous c()何ulation factor and D - Dimer the first day after OLT andD 叩 Dimer in the third day after OLT. Re州ts 四e surveillance of pf and APIT ín 负ve patients before and after OLT were no si伊ificant diffi晤erence. The maín decrease in endogenous coagulation factor事 Wω 泪 and XIl. The maín decre脚in exogenous co锦ulation factors were D 、明、 X. D - Dimer ín the first day after OLT increased si阴岱canùy and decreased in the third day markedly , but most of it was still hígher than that in normal. Conc)usion 币lere are phenomena in deficiency of endogenous and exogenous co叩lation factors after OLT and exogenous coa伊lation facto