开胸心脏手术对血小板的影响

Effects of thoracotomy and heart operation on platelet

目的探讨开胸心脏手术对血小板的影响。方法7只绵羊进行模拟开胸心脏手术,分别于开胸前、外科操作结束时及结束后2 h采血行人工血小板计数。结果7只绵羊手术操作完成后2 h与开胸前相比血小板显著减少(P<0.001);与操作完成时相比也显著降低(P=0.005);操作完成时与开胸前相比无显著性差异(P=0.251)。术中出血量多的绵羊,不但操作完成后2 h与开胸前和操作完成时相比血小板显著降低(P<0.001),而且操作完成时与开胸前相比血小板也明显减少(P=0.033)。结论开胸心脏手术可引起血小板明显的减少,避免血小板的大量消耗,关键是熟练手术操作,减少术中出血。

Objective： The aim of the present study was to determine the effect of thoracotomy and operation on heart on platelet. Methods： A mimic thoracotomy and operation on heart was performed in 7 sheep. Blood samples were taken to count platelet at following time points, before thoracotomy, surgical manipulation finished, and two hours subsequently. Results： Platelet count in 7 sheep decreased significantly on 2hrs after operation compared with the count before thoracotomy （P 〈0.01 ） and the count when surgical manipulation had been finished （P =0.05 ） , however, platelet count did not decrease significantly when surgical manipulation had been finished compared with the count before thoracotomy （ P = 0.251 ）. In 3 sheep with more bleeding, platelet count not only dropped on 2hrs after operation （compared with the count before thoracotomy and when surgical manipulation had been finished, P 〈 0. 001, respectively） , but also decreased significantly when surgical manipulation had been finished （compared with the count before thoracotomy, P =0. 033）. Conclusion： The thoracotomy and operation on heart could cause a significant decrease in platelet count. The key method to avoid it was to be good at operative procedure and to reduce bleeding in operation.