目的 比較進(jìn)展性慢性肝病及重癥肝炎患者原位肝移植(OLT)圍手術(shù)期凝血功能的變化。
方法 回顧性分析我中心2004年1月至2005年12月期間行OLT治療進(jìn)展性慢性肝病及重癥肝炎患者各37例的圍手術(shù)期血小板(PLT)、凝血酶原時(shí)間(PT)、活化部分凝血活酶時(shí)間(APTT)及纖維蛋白原(FIB)的變化。結(jié)果 2組患者除術(shù)前PT、APTT,術(shù)后第5 d PLT、FIB和術(shù)后第7 d FIB的差異有統(tǒng)計(jì)學(xué)意義外（p lt;0.05），其余時(shí)段2組患者的PLT、PT、APTT及FIB 間差異均無統(tǒng)計(jì)學(xué)意義（P gt;0.05）, 提示重癥肝炎患者凝血功能損害更為嚴(yán)重； OLT術(shù)后，2組患者的凝血功能均逐漸恢復(fù)正常, 但并非完全同步。結(jié)論 進(jìn)展性慢性肝病與重癥肝炎患者OLT圍手術(shù)期凝血功能變化顯著，應(yīng)注意監(jiān)測及處理，但術(shù)后2組間各指標(biāo)間比較差異并不明顯。
引用本文： 鄧小凡,呂波,陳鵬,文天夫,曾勇,李波,嚴(yán)律南. 進(jìn)展性慢性肝病與重癥肝炎患者肝移植圍手術(shù)期凝血功能的變化. 中國普外基礎(chǔ)與臨床雜志, 2008, 15(2): 126-128. doi: 復(fù)制
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- 1. <><><> [1]劉永鋒主譯.肝臟移植[M].第3版.北京:人民衛(wèi)生出版社,2004:4～28.
- 2. 病毒性肝炎防治方案中華醫(yī)學(xué)會(huì)傳染病與寄生蟲病學(xué)分會(huì)、肝病學(xué)分會(huì)聯(lián)合修訂[J].肝臟,2000; 5(4):257.
- 3. Amitrano L,Guardascione MA,Brancaccio V,et al.Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis[J].J Hepatol,2004; 40(5):736.
- 4. Lorenz R,Kienast J,Otto U,et al.Efficacy and safety of a prothrombin complex concentrate with two virus-inactivation steps in patients with severe liver damage[J].Eur J Gastroenterol Hepatol,2003; 15(1):15.
- 5. Faeh M,Hauser SP,Nydegger UE.Transient thrombopoietin peak after liver transplantation for end-stage liver disease[J].Br J Haematol,2001; 112(2):493.
- 6. 殷麗.纖維蛋白原檢測在臨床上的應(yīng)用[J].現(xiàn)代中西醫(yī)結(jié)合雜志,2006; 15(1):120.
- 7. 王卓強(qiáng),石炳毅,劉秀珍,等.肝臟移植圍麻醉期凝血功能的監(jiān)測與調(diào)控[J].解放軍醫(yī)學(xué)雜志,2003; 28(10):866.
- 8. Kaneko J,Sugawara Y,Tamura S,et al.Coagulation and fibrinolytic profiles and appropriate use of heparin after living-donor liver transplantation[J].Clin Transplant,2005; 19(6):804.
- 9. Bombeli T,Spahn DR.Updates in perioperative coagulation:physiology and management of thromboembolism and haemorrhage[J].Br J Anaesth,2004; 93(2):275.
- 10. 李汛,李玉民,石斌,等.肝移植術(shù)后肝動(dòng)脈血栓的防治(附2例報(bào)告)[J].中國普外基礎(chǔ)與臨床雜志,2005; 12(5):511.
- 11. 賴威,盧實(shí)春,趙紀(jì)春.前列地爾在肝移植中使用的臨床意義評價(jià)[J].消化外科,2004; 3(5):306.