摘要
目的 应用血栓弹性描记图 (thrombelastography,TEG)监测 92例肝癌患者围手术期凝血功能状态的变化。方法 92例Ⅰ～Ⅱ期肝癌手术病例 ,在术前、切皮后 1h、切皮后 2h、术毕、术后 12h检测TEG ;另外选择 5 0例健康者作为对照。结果 84 .8% (78 92 )的肝癌患者术前TEG表现为较典型的高凝图像 :γ值 (6 .0 2± 1.39)min、K值 (1.6 8± 0 .38)min、α角 (6 7.0 6± 4 .86 )°、Ma值 (6 9.85± 6 .91)mm ;和正常组比较有显著性差异 (P <0 .0 1)。随着手术的进行 ,γ和K进一步缩短 ;α、Ma进一步增大 ;并有显著性意义 (P <0 .0 5 )。 6 .5 % (6 92 )的病例术后出现早期纤溶亢进倾向。结论 大多数肝癌患者的凝血功能呈现病理性高凝状态 ,TEG监护在肝癌手术中具有较高的临床运用价值。
Objective To investigate the perioperative coagulable states of patients with liver cancer monitored by thrombelastography (TEG). Methods TEG was measured in 92 patients with liver cancer at the time of preoperation, 1h and 2h following the operation beginning, immediately after operation and 12h after operation. And TEG was measured in 50 normal control,too. Comparisons were made between liver cancer and normal control. Results The hypercoagulable sign of the most liver cancer (78/92) were showed that γ value (6.02±1.39min)?K value (1.68±0.38min) are obvious short and Ma value (69.85±6.91mm)?α(67.06±4.86 o) are obvious wide,compared with normol control (P<0.01). Hypercoagulable states are more obvious along with the operative progressing. The tendency of fibroprotein dissolve was found in 6.5% of patients. Conclusion Hypercoagulable states existed in most patients with liver cancer. It was suggested that TEG may also be an useful tool to screen patients with hypercoagulable states.
出处
《重庆医学》
CAS
CSCD
2002年第10期924-926,共3页
Chongqing medicine
