CAJ | 학술논문

目的：探讨产妇分娩前后凝血与纤溶指标监测的意义。方法产后出血组（出血量大于或等于500 mL）212例和正常分娩组235例，检测产前及产后72 h 血浆凝血酶原时间（PT）、国际标准化比值（PT-INR）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、凝血酶时间（TT）、D-二聚体（DD）、血小板（PLT）和血红蛋白（HB），健康体检女性85例作为健康组。结果产前比较：正常分娩组 PT/PT-INR、APTT、TT、PLT、HB 低于健康组，FIB、DD 高于健康组；产后出血组 PT/PT-INR、APTT、TT、DD 高于正常分娩组，FIB、PLT 低于正常分娩组。产后比较：正常分娩组 PT/PT-INR、APTT、TT、DD 与健康组比较差异无统计学意义（P ＞0．05），但 FIB 高于健康组；产后出血组 PT/PT-INR、APTT、TT、DD 高于正常分娩组，FIB、PLT、HB 低于正常分娩组。结论产前及产后动态监测各项凝血与纤溶指标变化对预防产后出血、血栓形成具有重要意义。
목적：탐토산부분면전후응혈여섬용지표감측적의의。방법산후출혈조（출혈량대우혹등우500 mL）212례화정상분면조235례，검측산전급산후72 h 혈장응혈매원시간（PT）、국제표준화비치（PT-INR）、활화부분응혈활매시간（APTT）、섬유단백원（FIB）、응혈매시간（TT）、D-이취체（DD）、혈소판（PLT）화혈홍단백（HB），건강체검녀성85례작위건강조。결과산전비교：정상분면조 PT/PT-INR、APTT、TT、PLT、HB 저우건강조，FIB、DD 고우건강조；산후출혈조 PT/PT-INR、APTT、TT、DD 고우정상분면조，FIB、PLT 저우정상분면조。산후비교：정상분면조 PT/PT-INR、APTT、TT、DD 여건강조비교차이무통계학의의（P ＞0．05），단 FIB 고우건강조；산후출혈조 PT/PT-INR、APTT、TT、DD 고우정상분면조，FIB、PLT、HB 저우정상분면조。결론산전급산후동태감측각항응혈여섬용지표변화대예방산후출혈、혈전형성구유중요의의。
Objective To investigate the significance of detection of blood coagulation and fibrinolytic indexes before and after delivery.Methods 212 cases in the postpartum hemorrhage group(bleeding amount ≥500 mL)and 235 cases in the normal deliver-y group were retrospectively analyzed.The prothrombin time(PT),international normalized ratio(PT-INR),activated partial throm-boplastin time(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer(DD),blood platelets(PLT)and hemoglobin(HB)were de-tected before delivery and at 72 h after delivery.85 women with the physical examination were selected as the healthy group.Results Before delivery,PT/PT-INR,APTT,TT,PLT and HB in the normal delivery group were lower than those in the healthy group, while FIB and DD were higher than those in the healthy group;PT/PT-INR,APTT,TT and DD in the postpartum hemorrhage group were higher than those in the normal delivery group,while FIB and PLT were lower than those in the normal delivery group. At 72 h after delivery,there was no statistically significant differences in PT/PT-INR,APTT,TT and DD between the normal de-livery group and the healthy group(P >0.05),but FIB was higher than that in the healthy group;PT/PT-INR,APTT,TT and DD in the postpartum hemorrhage group were higher than those in the normal delivery group,while FIB,PLT and HB were lower than those in the normal delivery group.Conclusion Dynamically monitoring the change of the blood coagulation and fibrinolysis indexes before and after delivery has important significance in preventing postpartum hemorrhage and thrombosis.