上矢状窦结扎后不同程度的颅内压增高对兔凝血功能的影响

目的探讨兔上矢状窦结扎后颅内压增高程度不同时D-二聚体、纤维蛋白原和血液流变学的变化。方法采用成年健康El本大耳白兔90只，随机分为5组：A组为结扎上矢状窦后1／3段及其皮层回流静脉，B、C、D组为在结扎基础上分别放置0．2、0．4、0．6ml硬膜外球囊，E组为假手术组；各组均再分为术后8、24、48h三亚组，每亚组6只。术后测定各组D-二聚体、纤维蛋白原和血液流变学变化。结果术后48h，B、C和D组血纤维蛋白原水平均明显高于E组（P〈0．05），A组与E组之间无明显差异（P〉0．05）。术后8、24、48h，D组血纤维蛋白原水平均明显高于A组（P〈O．05）。然而，各组血D-二聚体水平在术后所有时间点均无统计学差异（P〉0．05）。术后48h，除血浆粘度以外，B、C和D组血液流变学各指标均明显高于E组（P〈O．05），A组与E组之间无明显差异（P〉0．05）。术后8、24、48h，D组血液流变学各指标均明显高于A组（P〈O．05）。结论兔上矢状窦结扎后颅内压增高可促发高凝状态的形成。

Effect of different increases in intracranial pressure on blood coagulation function after ligation of superior sagittal sinuses in rabbits

Objective To investigate the effect of different increases in intracranial pressure （ICP） on the blood coagulation function after the ligation of the superior sagittal sinuses （SSS） in rabbits. Methods Ninety Japanese Big-ear Rabbits were randomly divided into five groups, i.e. Group A in which the rabbits underwent ligation of the posterior 1/3 of SSS. Groups B, C and D in which the rabbits underwent the ligation of the posterior 1/3 of SSS followed by the placement of a balloon （0.2 ml, 0.4 ml, 0.6 ml respectively） into the epidural space, and Group E in which the rabbits underwent sham-operation. Then each group was re-divided into three subgroups according to the survival time （including 8, 24 and 48 hours after the operation respectively）. Each subgroup contained 6 rabbits. The serum levels of D-dimer and fibrinogen and the indexes of blood theology were detected in all the groups. Results The serum levels of fibrinogen were significantly higher in groups B, C and D than those that in group E （P〈0.05） 48 hours after the operation. The serum levels of fibrinogen were also significantly higherin group D than in group A 8, 24 and 48 hours after the operation （P〈0.05）. There were no significant differences in the serum levels of D-dimer among all the groups 8, 24 and 48 hours after the operation （P〉0.05）. The indexes of blood rheology except plasma viscosity significantly increased in groups A, B, C and D compared to those in group E （P〈0.05） 48 hours after the operation. Moreover, the indexes of blood rheology except plasma viscosity significantly increased in group D compared to group A 8, 24 and 48 hours after the operation （P〈0.05）. Conclusion The increase in ICP after SSS ligation can promote the formation of hypercoagulable state in the rabbits.