阻塞性黄疸患者围手术期凝血功能临床研究.docVIP

阻塞性黄疸患者围手术期凝血功能临床研究 谢步飞1 朱紫苗2 (1温州龙湾区第一人民医院 温州龙湾325024； 2温州市中心血站 325001) 【摘要】目的主要研究围手术期阻塞性黄疸患者的凝血功能发牛的变化。方法 实验组为30例进行经皮肝穿胆道引流术阻塞性黄疸患者，在术前、术后第1、7、 14天晨取血浆进行血液学检测，检测项目包括纤维蛋白原降解产物(FDP)、D■二聚 体(D?D)、血管性血友病因子(VWF)、纤维蛋白原(FIB)、抗凝血酶山(AT?山)、凝血 酶原时间(PT)、活化部分凝血活酶时间(APTT),其中FDP采用ELISA方法检测、D-D 和VWF采用免疫浊度法、FIB采用Clauss法、AT?UI釆用发色底物法、PT和APTT 为自动血凝法。进行常规疗法的20例患者为对照组。结果实验组与对照组的 FIB、FDP、D?D、VWF和AT-山存在显著差异;实验组患者术后FIB、FDP和D-D含 量术后均升高，术后第7天水平最高,术后第14天仍未恢复至正常;VWF含量围手 术期均显著升高;AT?HI术前最高,术后降至正常范围。PT和APTT手术前后变化不 大，与对照组无差异。结论阻塞性黄疸患者术前存在高凝状态，术后早期凝血功 能下降，术后第7天再次出现高凝状态，至术后第14天仍未改善。 【关键词】阻塞性黄疸患者 围手术期 凝血功能 【中图分类号】R657 【文献标识码】A 【文章编号】2095-1752 (2013) 23-0124-02 [Abstract] Objective: the main research perioperative obstructive jaundice patients changes in blood clotting. Methods: the for 30 patients undergo percutaneous liver biopsy biliary drainage of obstructive jaundice patients, in preoperative and postoperative 1, 7,14 days on morning take the hematology testing, plasma projects including fibrinogen degradation products (FDP), D ? dimers (D ? D), wd factor (VW F), fibrinogen (FIB), anticoagulant enzyme LU (AT-山)，prothrombin time (PT) activation part blood coagulation time (APTT) live enzymes, including FDP adopts EL ISA method detection, D - D and VWF by immune turbidity method, Clauss method, A FIB adopted by LU T - hair color substrates method, PT and APTT for automatic blood coagulation method. Routine therapy 20 patients (control group). Results: the FDP FIB, with control, D - D, VW F and A T ? there were significant differences LU; Patients who underwent the FDP FIB, experimental and D-D levels rise, the number of all the seven days, the highest level in 14 days still not return to normal; VW F content perioperative were sign ifica ntly in crease; AT- LU preoperative supreme, postoperative drop to the normal range. PT and little change APTT before and after operation, no differenee with the control group. Conclusion: obstructive jaundice patients pre-existent high pour-point state, early pos