中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2001年
1期
18-19
,共2页
姚兴发%叶金玉%王连元%贾巧%廖茂斌%杨斌%彭立辉%石磊%王滨
姚興髮%葉金玉%王連元%賈巧%廖茂斌%楊斌%彭立輝%石磊%王濱
요흥발%협금옥%왕련원%가교%료무빈%양빈%팽립휘%석뢰%왕빈
血液粘滞度%红细胞压积%血沉%纤维蛋白原%外科手术%犬
血液粘滯度%紅細胞壓積%血沉%纖維蛋白原%外科手術%犬
혈액점체도%홍세포압적%혈침%섬유단백원%외과수술%견
目的 为探讨手术后缺血性心、脑血管病的发病机理。 方法 应用8条犬于颞骨切除术后不用任何治疗 ,连续观察5d内血液流变学的变化。结果 犬术后2h全血粘度明显升高(P <0.05) ,24h后恢复并稳定在正常状态;血浆粘度一直无明显改变;血沉于术后24h明显加快(P <0.05),持续至5d;纤维蛋白原亦于2h后开始增加,至第5d时具有统计学意义(P <0.05);而红细胞压积于术后2h明显升高(P<0.05),24h显著下降(P<0.05) , 也持续至5d,并与全血粘度的改变呈正相关(r=0.7778,P<0.05)。结论 在正常生 理情况下,手术可引起血液流变学的显著异常,但由于机体的自我调节作用,24h以内红细 胞压积下降,血粘度恢复正常,并稳定至5d以后,而对血沉加快和纤维蛋白原升高的调节作 用不明显。因此,为了预防手术后早期发生缺血性心、脑血管疾病,应在手术后24h以内采 用血液稀释疗法,而24h以后则应针对血沉加快及纤维蛋白原增加予以治疗。
目的 為探討手術後缺血性心、腦血管病的髮病機理。 方法 應用8條犬于顳骨切除術後不用任何治療 ,連續觀察5d內血液流變學的變化。結果 犬術後2h全血粘度明顯升高(P <0.05) ,24h後恢複併穩定在正常狀態;血漿粘度一直無明顯改變;血沉于術後24h明顯加快(P <0.05),持續至5d;纖維蛋白原亦于2h後開始增加,至第5d時具有統計學意義(P <0.05);而紅細胞壓積于術後2h明顯升高(P<0.05),24h顯著下降(P<0.05) , 也持續至5d,併與全血粘度的改變呈正相關(r=0.7778,P<0.05)。結論 在正常生 理情況下,手術可引起血液流變學的顯著異常,但由于機體的自我調節作用,24h以內紅細 胞壓積下降,血粘度恢複正常,併穩定至5d以後,而對血沉加快和纖維蛋白原升高的調節作 用不明顯。因此,為瞭預防手術後早期髮生缺血性心、腦血管疾病,應在手術後24h以內採 用血液稀釋療法,而24h以後則應針對血沉加快及纖維蛋白原增加予以治療。
목적 위탐토수술후결혈성심、뇌혈관병적발병궤리。 방법 응용8조견우섭골절제술후불용임하치료 ,련속관찰5d내혈액류변학적변화。결과 견술후2h전혈점도명현승고(P <0.05) ,24h후회복병은정재정상상태;혈장점도일직무명현개변;혈침우술후24h명현가쾌(P <0.05),지속지5d;섬유단백원역우2h후개시증가,지제5d시구유통계학의의(P <0.05);이홍세포압적우술후2h명현승고(P<0.05),24h현저하강(P<0.05) , 야지속지5d,병여전혈점도적개변정정상관(r=0.7778,P<0.05)。결론 재정상생 리정황하,수술가인기혈액류변학적현저이상,단유우궤체적자아조절작용,24h이내홍세 포압적하강,혈점도회복정상,병은정지5d이후,이대혈침가쾌화섬유단백원승고적조절작 용불명현。인차,위료예방수술후조기발생결혈성심、뇌혈관질병,응재수술후24h이내채 용혈액희석요법,이24h이후칙응침대혈침가쾌급섬유단백원증가여이치료。
Objective To understand the effects of operation (or trauma) on hemorrheology and in order to clarify the pathogenesis of ischemic cardiovascular and cerebrovascular disease s.The changes of blood viscosity,plasma viscosity,hematocrit (HCT),erythrocy te sedimentation rate(ESR) and fibrinogen(FG) were detected at 2,24,7 2 and 120 hours,respectively,after operation in subtemporal craniotomied dogs( n=8) without any treatment.Results:⑴The blood viscosity wa s increased significantly at 2 hours after operation ,it was recovered to norm al after 24 hours.On the other hand,the plasma viscosity didn't change at all.⑵Both the HCT and ESR were risen significantly at the postoperation,continued over 120 hours.⑶FG was obviously elevated until the 120 hours.⑷The change of blood viscosity was positively correlated wit h HCT.Conclusions:The operation (or trauma) might cause th e change of h emorrheology,but by self-regulation of the dogs,the HCT reduced within 24 hours, and the blood viscosity recovered to normal level,and persisted over 5 days. Th e self-regulating ability on ESR and FG levels was very limit within 120 hours.Prevention of postoperative (or post-traumatic) ischem ic di seases of heart and brain,blood dilution therapy should be performed as soon as possible in the postoperation or post-trauma within 24 hours.After 24 hours,the therapy to reduce the levels of FG and ESR should be adopted as main method.