背驮式肝移植术中凝血功能变化

目的 研究55例背驮式肝移植术中凝血功能变化与监测手段。方法 55例背驮式式肝移植病例，在术前、切皮后0.5h、无肝期0.5h、吻合血管开放前15min、开放后10min，术毕抽血检测血栓弹性描记图（thrombelastography,TEG)和凝血三项（PT、APTT、Fg)。结果 术前处在轻度的低凝状态（总凝血指数－3.318)，吻合血管开放前一直保持相对的稳定；开放后呈现明显的低凝状态（总凝血指数－7.707)，一直持续到手术结束。在开放后有9例患者出现纤溶状态。结论 背驮式肝移植手术在开放前凝血功能较稳定，开放后呈现明显的低凝状态，有时出现纤溶状态，需要及时纠正。

Changes of coagulative function during operation of piggyback liver tansplantation

Objective To investigate the changes of coagulative function and detective methods during operation of piggyback liver tansplantation.Methods Fifty five cases of piggyback liver transplantation, 3ml venous blood was withdraw for TEG and coagulative function(PT,APTT,Fg) at time point of preoperation,0.5h after operation,0.5h of anhepatic phase,15min before opening,10min after opening and operation finished.Results Low coagulative behavior existed in preoperation, and kept relative stable before opening. Low coagulative behavior was more obvious after opening( P <0.05), and lasted to operation finished. Nine cases presented fibrin dissolved.Conclusion The coagulative function kept stable before opening and obvious low coagulative behavior presented after opening, sometime fibrin dissolved presented. It needed redress in time.