目的 比较进展性慢性肝病及重症肝炎患者原位肝移植(OLT)围手术期凝血功能的变化。
方法 回顾性分析我中心2004年1月至2005年12月期间行OLT治疗进展性慢性肝病及重症肝炎患者各37例的围手术期血小板(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及纤维蛋白原(FIB)的变化。结果 2组患者除术前PT、APTT,术后第5 d PLT、FIB和术后第7 d FIB的差异有统计学意义外（p lt;0.05），其余时段2组患者的PLT、PT、APTT及FIB 间差异均无统计学意义（P gt;0.05）, 提示重症肝炎患者凝血功能损害更为严重； OLT术后，2组患者的凝血功能均逐渐恢复正常, 但并非完全同步。结论 进展性慢性肝病与重症肝炎患者OLT围手术期凝血功能变化显著，应注意监测及处理，但术后2组间各指标间比较差异并不明显。
Citation：
邓小凡,吕波,陈鹏,文天夫,曾勇,李波,严律南. Changes on Perioperative Coagulation Function of Orthotopic Liver Transplantation inPatients with Advancing Chronic Hepatopathy and Fulminant Hepatitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(2): 126-128. doi:
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<><><> [1]刘永锋主译.肝脏移植[M].第3版.北京:人民卫生出版社,2004:4～28.
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Amitrano L,Guardascione MA,Brancaccio V,et al.Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis[J].J Hepatol,2004; 40(5):736.
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Lorenz R,Kienast J,Otto U,et al.Efficacy and safety of a prothrombin complex concentrate with two virus-inactivation steps in patients with severe liver damage[J].Eur J Gastroenterol Hepatol,2003; 15(1):15.
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Faeh M,Hauser SP,Nydegger UE.Transient thrombopoietin peak after liver transplantation for end-stage liver disease[J].Br J Haematol,2001; 112(2):493.
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殷丽.纤维蛋白原检测在临床上的应用[J].现代中西医结合杂志,2006; 15(1):120.
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王卓强,石炳毅,刘秀珍,等.肝脏移植围麻醉期凝血功能的监测与调控[J].解放军医学杂志,2003; 28(10):866.
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Kaneko J,Sugawara Y,Tamura S,et al.Coagulation and fibrinolytic profiles and appropriate use of heparin after living-donor liver transplantation[J].Clin Transplant,2005; 19(6):804.
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| 9. |
Bombeli T,Spahn DR.Updates in perioperative coagulation:physiology and management of thromboembolism and haemorrhage[J].Br J Anaesth,2004; 93(2):275.
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| 10. |
李汛,李玉民,石斌,等.肝移植术后肝动脉血栓的防治(附2例报告)[J].中国普外基础与临床杂志,2005; 12(5):511.
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赖威,卢实春,赵纪春.前列地尔在肝移植中使用的临床意义评价[J].消化外科,2004; 3(5):306.
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- 1. <><><> [1]刘永锋主译.肝脏移植[M].第3版.北京:人民卫生出版社,2004:4～28.
- 2. 病毒性肝炎防治方案中华医学会传染病与寄生虫病学分会、肝病学分会联合修订[J].肝脏,2000; 5(4):257.
- 3. Amitrano L,Guardascione MA,Brancaccio V,et al.Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis[J].J Hepatol,2004; 40(5):736.
- 4. Lorenz R,Kienast J,Otto U,et al.Efficacy and safety of a prothrombin complex concentrate with two virus-inactivation steps in patients with severe liver damage[J].Eur J Gastroenterol Hepatol,2003; 15(1):15.
- 5. Faeh M,Hauser SP,Nydegger UE.Transient thrombopoietin peak after liver transplantation for end-stage liver disease[J].Br J Haematol,2001; 112(2):493.
- 6. 殷丽.纤维蛋白原检测在临床上的应用[J].现代中西医结合杂志,2006; 15(1):120.
- 7. 王卓强,石炳毅,刘秀珍,等.肝脏移植围麻醉期凝血功能的监测与调控[J].解放军医学杂志,2003; 28(10):866.
- 8. Kaneko J,Sugawara Y,Tamura S,et al.Coagulation and fibrinolytic profiles and appropriate use of heparin after living-donor liver transplantation[J].Clin Transplant,2005; 19(6):804.
- 9. Bombeli T,Spahn DR.Updates in perioperative coagulation:physiology and management of thromboembolism and haemorrhage[J].Br J Anaesth,2004; 93(2):275.
- 10. 李汛,李玉民,石斌,等.肝移植术后肝动脉血栓的防治(附2例报告)[J].中国普外基础与临床杂志,2005; 12(5):511.
- 11. 赖威,卢实春,赵纪春.前列地尔在肝移植中使用的临床意义评价[J].消化外科,2004; 3(5):306.
