摘要
目的观察肝移植术中常规凝血检测和血栓弹性图对凝血机能调控的相关性分析。方法26例终末期肝病患者在静吸复合全身麻醉下行肝移植术。分别于麻醉后60min,无肝期30min,新肝期后30min经中心静脉采血测定常规凝血检测指标:PT,APTT,INR,PLT计数,FIB,TEG指标测定:R,K,a,MA。结果无肝期30min与麻醉后60min相比,常规凝血检测及TEG指标差异无显著性,而新肝期常规凝血检测和TEG指标均变化明显。常规凝血检测PT、APTT、INR从无肝期至新肝期逐渐延长。麻醉后60minPT、APTT、INR分别为(18.98±3.27)min、(64.02±22.48)min、2.97±3.97;新肝期PT、APTT、INR分别为(30.00±7.34)min、(94.59±24.26)min、4.94±2.60,两者延长有显著性差异[P﹤0.05(R);P﹤0.01(PT、APTT)],而PLT及FIB变化无显著性差异。TEG中仅R值在新肝期(7.80±3.49)与麻醉后(6.15±2.61)比较差异有显著性(P﹤0.05),其他指标变化不显著。PT和K呈正相关(r=0.476,P﹤0.05),MA和FIB、PLT呈正相关(r=0.465,0.396,P﹤0.05)。结论肝移植术中新肝期前后凝血变化明显,TEG指标与传统的凝血指标具有一致性而且TEG监测快速、简单且能动态地反应凝血全过程,对临床治疗有指导作用。
Objective To study the correlation coagulation control between TEG and conventional blood coagualation monitoring in liver transplantation.Methods 26patients undergoing OLT were studied vein bloodsamples were drawn from an existing vein line for determination of PT,APTT,INR,PLT,FIB and TEG at three time points at：60 min after anesthesia,30 min during anhepatic period and 30 min after reperfusion.Results Compared with the values 60 min after anesthesia,all the values showed nosignificant differences at 30 min during anhepatic period,and all the values showed significant differences at 30 min after reperfusion.PT、APTT、INR、R gradually extendedfron anhepatic period to reperfusion period,showed significant differences （P 〈0.05 or P 〈0.01）. There was a positive correlation between PT and R （r=0.476,P﹤0.05）;MA and FIB,the number of PLT （r=0.465,0.396,P﹤0.05）.Conclusion Blood coagulation disorder occurs mainly during reperfusion period.A positive correlation exists between the values of TEG ang conventional blood coagulation monitoring and TEG can give some quick,simple guidance in liver transplantation.
出处
《北京医学》
CAS
2010年第3期204-206,共3页
Beijing Medical Journal
关键词
肝移植
凝血检测
血栓弹性图
Liver transplantation Coagulation monitoring Thrombelastograph
