原发性肝癌和胆囊结石症患者手术前后血液流变学初步观察

作者检测原发性肝癌11例及胆囊结石症16例外周静脉血的血液流变特性,初步观察结果表明,手术后的血液粘度明显高于术前(P<0.01),肝癌患者的增高较胆囊结石患者更为明显(P<0.01)。其原因可能与手术创伤及术中、术后过多输入库存血、血浆和白蛋白等高渗溶液有关。血液稀释疗法可以缓解术后血液的粘度状态,维持血细胞比容在0.30～0.35,能改善微循环,保持组织供氧不变。

Preliminary Observation on Pre-and Post-Operative Hemor-heology in the Patients with Primary Liver Cancer and Gallstone

Changes of pre- and post-operative hemorheology in 27 patients, 11 with primary liver cancer (PLC) and 16 with gallstone (GS),were observed. The results show that the viscosity of blood in postoperative patients with PLC and GS increased significantly as compared with that in preoperative patients (P<0.01), and was higher in patients with PLC than in patients with GS (P<0.01). The causes of high viscosity of blood after operation may be: decreased deformability of red blood cells, increased hematocrit, increased blood coagulability, transfusion of preserved blood with higher viscosity, and postoperative reaction of stress. High viscosity may result in decrease of blood perfusion in microcirculatory system, increasing risk of deep venous thrombosis and attack of coronary heart disease. The hemodilution may improve the postoperative situation of high viscosity, and hematocrit kept within 0.30-0.35 can improve micro-circulatory system and maintain tissue oxygen supply. Deep venous thrombosis is prevented by heparin when needed.