关节手术病人血浆凝血酶-抗凝血酶复合物、纤溶酶-α_2抗纤溶酶复合物的研究

Research of TAT and PAP in joint operation patients

目的探讨髋、膝关节手术病人血栓前状态和血液中凝血-纤溶系统的变化。方法每组病人术前及术后1、4、7、10天检测TAT、PAP、血凝常规等指标;术前及术后第7天￣10天应用彩色多普勒超声仪监测DVT。结果①手术组共有18例(40.9%)术后并发DVT,保守组共有9例(22.0%)并发DVT,对照组无DVT发生;②手术组术后并发DVT者术前及术后TAT均显著升高,而PAP水平较低;③术后并发DVT者与术前PAP/FB比值相关。结论①术前TAT检测可作为术后是否并发DVT的一项较有意义的预测指标。②术前较低的纤溶水平可能成为髋、膝关节置换术后DVT发病率高的原因之一。③术前血浆PAP/FB比值有望成为预测术后DVT的有用指标。

Objective Evaluate the prethrombus and coagulation-fibrinolytic system changes in hip joint and knee joint operation patients. Methods The blood coagulation routine was test before operation and on 1, 4, 7, 10 days after operation. DVT was tested using Doppler ultrasound diagnostic apparatus before operation and 7 to 10 days after operation. Results ① 18 cases in operation group and 9 cases in conservative group were complicated by DVT. No DVT in contrast group. ②In operation group with DVT, TAT level was higher and PAP level was lower before and after operation. ③Patients with DVT after operation were interrelated with PAP/FB. Conclusion ①Testing TAT before operation can be regarded as a significant forecast factor whether DVT will happen after operation. ②Preoperative lower fibfinolytic level may be a cause of high DVT incidence after operation of hip or joint replacement surgery, ③Preoperarive PAP/FB may be a forecast factor of DVT after operation.