6种凝血指标在肝移植术中表达及意义

目的:动态观察异体原位肝脏移植术前、中、后凝血机制6项指标,了解围手术期凝血状态.方法:在61例异体原位肝脏移植患者于手术前期、术中无肝前期、无肝期40分钟、新肝期30分钟、新肝期90分钟和术后,检测凝血酶原(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fbg)、D-2聚体(D-D)、血小板数(Plt)的变化.结果:与正常对照组相比,术前PT、APTT值高于正常,Fbg、Plt、TT、D-D值接近正常.术后2周内6项凝血指标均超高于正常.新肝期PT和APTT值高于无肝期,新肝90分钟时高于新肝30分钟.术后约5～15天PT、APTT、Fbg和血小板恢复正常.结论:围肝移植术期中,新肝期凝血机制异常显著,术后2周内应加强凝血指标监测.

Expression and Significance of Six Clotting Indexes Related to the Blood Coagulation Mechanism during the Orthotopic Liver Transplantation

Objective;To learn the condition of blood coagulation changes the clotting indexes of the blood coagulation were observed dynamically during the orthotopic liver transplantation (OLT).Methods:Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fbg), thrombin (TT), D-Dimer (D-D), and platelet (Plt) were tested at preoperative, preohepatic,40 minutes of anhepatic,30 minutes of neohepatic,90 minutes of neohepatic times and after operation in 61 cases of OLT. ReSlllts:PT and APTT were prolonged significantly compared to control group before operation. The six clotting indexes were high than normal in two weeks after operation. PT and APTT in neohepatic time were high than anhepatic and in 90 minutes of neohepatic high than 30 minutes of neohepatic; after operation. PT, APTT, Fbg, and Plt were recovered about 5-15 days after operation.Conclusion:The blood coagulation was abnormal at neohepatic phase during OLT. It was beneficial to monitor clotting indexes before and after operation.