重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2015年
10期
1334-1336,1339
,共4页
卜文豪%吴群林%骆喜宝%屠伟峰
蔔文豪%吳群林%駱喜寶%屠偉峰
복문호%오군림%락희보%도위봉
纤维蛋白原%手术期间%出血%凝血酶时间%部分促凝血酶原时间%凝血酶原时间
纖維蛋白原%手術期間%齣血%凝血酶時間%部分促凝血酶原時間%凝血酶原時間
섬유단백원%수술기간%출혈%응혈매시간%부분촉응혈매원시간%응혈매원시간
fibrinogen%intraoperative period%hemorrhage%thrombin time%partial thromboplastin time%prothrombin time
目的：探讨术前纤维蛋白原（FIB）单次目标给药，对腰椎后路减压椎间植骨融合内固定术（PLIF）术中出血及凝血功能的影响。方法选择腰椎间盘突出症（LDH）择期做 PLIF 的患者60例，依据术前 FIB 水平分为 FIB≥3．0 g／L 组（NC 组， n＝20）和低 FIB 组（FIB＜3．0 g／L，n＝40），低 FIB 组再分为低 FIB 对照组（LC 组，n＝20）和术前 FIB 单次给药组（PF 组，n＝20）。PF 组于麻醉诱导完成后输入纤维蛋白原；LC、NC 组于麻醉诱导完成后输入纤维蛋白原剂量所需溶媒等容积的生理盐水。3组患者于给药前、后测定凝血4项及用凝血和血小板功能分析仪测定激活凝血时间（ACT）、凝血速率（CR）、血小板功能（PF），术毕称量出血量。结果FIB 在给药后 PF 组为（3．75±0．23）g／L，明显高于 NC 组（2．62±0．33）g／L 和 LC 组（2．23±0．22）g／L， 3组比较差异有统计学意义（P ＜0．05）；CR 值在给药后 PF 组为（21．42±7．15）U／min，高于 NC 组（18．21±5．62）U／min 和 LC组（15．21±5．63）U／min。PF 组出血量为（516．74±135．53）g，低于 NC 组（660．71±119．34）g 和 LC 组（726．72±160．47）g，3组比较差异有统计学意义（P ＜0．05）。结论术前 FIB 单次目标给药可以有效提高 FIB 水平及凝血功能，减少围术期出血量。
目的：探討術前纖維蛋白原（FIB）單次目標給藥，對腰椎後路減壓椎間植骨融閤內固定術（PLIF）術中齣血及凝血功能的影響。方法選擇腰椎間盤突齣癥（LDH）擇期做 PLIF 的患者60例，依據術前 FIB 水平分為 FIB≥3．0 g／L 組（NC 組， n＝20）和低 FIB 組（FIB＜3．0 g／L，n＝40），低 FIB 組再分為低 FIB 對照組（LC 組，n＝20）和術前 FIB 單次給藥組（PF 組，n＝20）。PF 組于痳醉誘導完成後輸入纖維蛋白原；LC、NC 組于痳醉誘導完成後輸入纖維蛋白原劑量所需溶媒等容積的生理鹽水。3組患者于給藥前、後測定凝血4項及用凝血和血小闆功能分析儀測定激活凝血時間（ACT）、凝血速率（CR）、血小闆功能（PF），術畢稱量齣血量。結果FIB 在給藥後 PF 組為（3．75±0．23）g／L，明顯高于 NC 組（2．62±0．33）g／L 和 LC 組（2．23±0．22）g／L， 3組比較差異有統計學意義（P ＜0．05）；CR 值在給藥後 PF 組為（21．42±7．15）U／min，高于 NC 組（18．21±5．62）U／min 和 LC組（15．21±5．63）U／min。PF 組齣血量為（516．74±135．53）g，低于 NC 組（660．71±119．34）g 和 LC 組（726．72±160．47）g，3組比較差異有統計學意義（P ＜0．05）。結論術前 FIB 單次目標給藥可以有效提高 FIB 水平及凝血功能，減少圍術期齣血量。
목적：탐토술전섬유단백원（FIB）단차목표급약，대요추후로감압추간식골융합내고정술（PLIF）술중출혈급응혈공능적영향。방법선택요추간반돌출증（LDH）택기주 PLIF 적환자60례，의거술전 FIB 수평분위 FIB≥3．0 g／L 조（NC 조， n＝20）화저 FIB 조（FIB＜3．0 g／L，n＝40），저 FIB 조재분위저 FIB 대조조（LC 조，n＝20）화술전 FIB 단차급약조（PF 조，n＝20）。PF 조우마취유도완성후수입섬유단백원；LC、NC 조우마취유도완성후수입섬유단백원제량소수용매등용적적생리염수。3조환자우급약전、후측정응혈4항급용응혈화혈소판공능분석의측정격활응혈시간（ACT）、응혈속솔（CR）、혈소판공능（PF），술필칭량출혈량。결과FIB 재급약후 PF 조위（3．75±0．23）g／L，명현고우 NC 조（2．62±0．33）g／L 화 LC 조（2．23±0．22）g／L， 3조비교차이유통계학의의（P ＜0．05）；CR 치재급약후 PF 조위（21．42±7．15）U／min，고우 NC 조（18．21±5．62）U／min 화 LC조（15．21±5．63）U／min。PF 조출혈량위（516．74±135．53）g，저우 NC 조（660．71±119．34）g 화 LC 조（726．72±160．47）g，3조비교차이유통계학의의（P ＜0．05）。결론술전 FIB 단차목표급약가이유효제고 FIB 수평급응혈공능，감소위술기출혈량。
Objective To investigate the effect of preoperative single target administrating of fibrinogen(FIB)on the intraop-erative bleeding and coagulation function in posterior lumbar interbody fusion (PLIF)operation.Methods 60 cases of lumbar inter-vertebral disc herniation(LDH)undergoing elective PLIF operation were divided into two groups according to the preoperative FIB levels:normal control group(NC,FIB≥3.0 g/L,n=20)and low FIB group(FIB<3.0 g/L,n=40).The low FIB group was ran-domly re-divided into 2 groups:the low HIB control group(LC,n=20)and the preoperative single FIB administrating group(PF, n=20).After anesthesia induction,the PF group was given FIB;the LC and NC groups were given the same volume of saline solu-tion as solvent volume required by administrating FIB dose.The change of blood coagulation 4 indexes were detected and the activa-ted clotting time(ACT),coagulation time(CR)and platelet function(PF)were detected by the sonoclot analyzer before and after drug administrating.The bleeding amount was weighed after ending operation.Results The FIB concentration after administrating in the PF group was (3.75±0.23)g/L,which was significantly higher than (2.62±0.33)g/L in the NC group and (2.23±0.22) g/L in the LC group,the differences among 3 groups were statistically significant(P <0.05);the CR value after administrating in the PF group was (21.42±7.15)U/min,which was higher than (18.21±5.62)U/min in the NC group and (15.21±5.63)U/min in the LC group.The bleeding amount in the PF group was (516.74±135.53)g,which was lower than (660.71±119.34)g in the NC group and (726.72±160.47)g in the LC group,the difference among 3 groups had statistical significance(P <0.05).Conclusion Preoperative single target administrating of fibrinogen can effectively increase the FIB level,improve the blood coagulation func-tion and reduce the periaoperative bleeding amount.
