CAJ | 학술논문

目的探讨脾切除断流术后早期抗凝治疗对患者凝血功能的影响.方法回顾性分析脾切除断流术后早期开始抗凝治疗106例患者的临床资料,术后24h开始应用低分子右旋糖酐500 ml+川芎嗪160 mg,持续1周,术后48 h再加用低分子肝素钙4 250 ～4 500 U每12h皮下注射1次,持续7 ～14d,术后3、5、7、10、14d检测凝血项.每周1～2次超声检查,了解门静脉系统血栓情况,严密观察切口和腹腔出血情况.结果血栓发生率为7.5％(8/106),部分凝血活酶时间(APTT)在用药7 ～14d后延长最为明显,其次为凝血酶原时间(PT)和凝血酶时间(TT)延长,纤维蛋白原(FIB)减少,但与正常值比较,各项指标的变化均无统计学意义.患者未发生明显的出血并发症.结论脾切除断流术后早期应用低分子肝素钙抗凝治疗对凝血指标有一定影响,但是无相关出血并发症发生,因此早期抗凝安全可行.
목적 탐토비절제단류술후조기항응치료대환자응혈공능적영향.방법 회고성분석비절제단류술후조기개시항응치료106례환자적림상자료,술후24h개시응용저분자우선당항500 ml+천궁진160 mg,지속1주,술후48 h재가용저분자간소개4 250 ～4 500 U매12h피하주사1차,지속7 ～14d,술후3、5、7、10、14d검측응혈항.매주1～2차초성검사,료해문정맥계통혈전정황,엄밀관찰절구화복강출혈정황.결과 혈전발생솔위7.5％(8/106),부분응혈활매시간(APTT)재용약7 ～14d후연장최위명현,기차위응혈매원시간(PT)화응혈매시간(TT)연장,섬유단백원(FIB)감소,단여정상치비교,각항지표적변화균무통계학의의.환자미발생명현적출혈병발증.결론 비절제단류술후조기응용저분자간소개항응치료대응혈지표유일정영향,단시무상관출혈병발증발생,인차조기항응안전가행.
Objective To explore the effect of early anticoagulation therapy on the blood coagulation in patients undergoing splenectomy plus devascularization.Methods Clinical data of 106 patients in Cangzhou Central Hospital from June 2000 to December 2012 were reviewed.Beginning 24 h after surgery,low molecular dextran 500 ml + ligustrazine 160 mg,once a day for 1 week,and after 48 h low molecular heparin calcium at 4 250 U to 4 500 U was given every 12 h for 7 to 14 d.Blood coagulation was tested on day 3,5,7,10 and 14,ultrasound 1-2 times a week was taken for detection of portal venous thrombosis.Results The incidence of portal thrombosis was 7.5％ (8/106).APTT prolonged during 7-14 d.Prothrombin time (PT),thrombin time (TT) and fibrinogen (FIB) decreased,but all the changes were not statistically significant when compared with the normal values(P ＞0.05).Anticoagulant treatment did not cause bleeding complications in this series.Conclusions Postoperative application of low molecular heparin calcium anticoagulant therapy is effective in the prevention of portal thrombosis and safe in terms of coagulation when started early in patients undergoing splenectomy.