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find Author "王振康" 2 results
  • 法洛四联症患者围手术期凝血功能变化及意义

    目的 探讨法洛四联症(TOF)患者围术期凝血功能变化及临床意义,以减少术后血液系统并发症的发生。 方法 将2005年1月至2008年8月我院收治的65例接受外科手术治疗的TOF患者纳入研究(实验组),选择同期手术的65例非紫绀型先天性心脏病患者作为对照(对照组)。检测两组患者术前及手术后1周的血气、血常规、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆Ⅷ和Ⅸ因子活性,并对各项指标术前、术后变化情况进行分析。 结果 组内比较:术后7 d实验组血红蛋白(Hb)和APTT均低于术前,动脉血氧分压(PaO2)、凝血因子Ⅷ和凝血因子Ⅸ均高于术前,PT变化不明显。组间比较:实验组术前Hb和APTT均高于对照组,PaO2、凝血因子Ⅷ和凝血因子Ⅸ均低于对照组(Plt;0.01)。 结论 TOF患者术前存在内源性凝血功能障碍,可能是自身凝血功能代偿以降低高粘血症带来的血栓形成危险,术后能得到改善,可能与血氧分压提高有关。

    Release date:2016-08-30 06:05 Export PDF Favorites Scan
  • Plasma Pro-and Anti-coagulation Factor Activity of Patients in the Perioperative Period of Surgical Correction for Tetralogy of Fallot and Its Clinical Significance

    ObjectiveTo investigate plasma pro-and anti-coagulation factor activity of patients in the perioperative period of surgical correction for tetralogy of Fallot (TOF) and its clinical significance. MethodsFrom January 2010 to April 2013, 47 patients undergoing surgical correction for TOF in Southern Hospital of Southern Medical University were enrolled in this study. There were 35 male and 12 female patients with their age of 1.20-26.00 (8.00±6.48) years and body weight of 8.70-46.00 (18.20±21.50) kg. Preoperatively and on the 4th, 7th and 10th postoperative day, activity of plasma coagulation factor Ⅱ, Ⅶ, Ⅷ, Ⅸ and Ⅹ, and antithrombin Ⅲ (ATⅢ) and protein C levels of all the patients were routinely measured, as well as prothrombin time (PT) and activated partial thromboplastin time (APTT). ResultsActivity of plasma coagulation factor Ⅱ (on the 4th postoperative day:102.66%±20.61% vs. 69.27%±16.51%), Ⅶ, Ⅷ, Ⅸ and Ⅹ(on the 4th postoperative day:125.43%±39.97% vs. 64.80%±11.46%) of TOF patients in the early postoperative period was significantly higher than preoperative level, reached the summit between the 4th and 7th postoperative day, and was still significantly higher than preoperative level on the 10th postoperative day. PT and APTT levels significantly decreased in the early postoperative period, and were still significantly lower than preoperative levels on the 10th postoperative day. Plasma AT Ⅲ and protein C levels were significantly increased in the early postoperative period but returned to preoperative levels on the 10th postoperative day. ConclusionsPreoperatively, haemostatic function of TOF patients is usually abnormal. Postoperative increased plasma procoagulant factor activity and recovered haemostatic function may be related to the correction of hypoxic state. In the early postoperative period, increased plasma procoagulant factor activity is helpful for haemostatic function. In the late postoperative period, an imbalance of provs anti-coagulation factors in plasma occurs towards stronger haemostatic function, which may increase the risk of thrombosis and render anticoagulant and antiplatelet therapy necessary.

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