多疗程高压氧治疗对患者凝血功能的影响

Effects of multiple courses of hyperbaric oxygen therapy on the blood coagulation function in patients

目的观察多疗程高压氧(HBO)治疗对患者凝血功能的影响。方法回顾性分析长期住院进行HBO治疗的27例患者,对血小板(PLT)计数、凝血酶原时间(PT)、凝血酶原时间活动度、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)等凝血指标进行比较。所有患者均在治疗前进行了凝血功能指标的化验检查。其中16例患者在3个疗程结束时,14例患者在5个疗程结束时,9例患者在7个疗程结束时,13例患者在8个疗程结束时,16例患者在10个疗程结束时进行了凝血功能指标的化验检查。结果HBO治疗3个疗程时,PLT计数与治疗前比较差异有统计学意义(P<0．01),8个疗程结束时差异也有统计学意义(P<0．05);PT与治疗前比较,只有5个疗程结束时的指标差异有统计学意义(P<0．05);各个时间点的FIB与治疗前比较均有下降趋势,但只有3个疗程结束时(P<0．01)和10个疗程结束时(P<0．05)的指标差异有统计学意义;HBO治疗结束,各个时间点的凝血酶原时间活动度和APTT两项指标与治疗前比较,差异无统计学意义(P>0．05)。结论多疗程HBO治疗对患者凝血功能并没有造成明显的不良影响。

Objective To observe the effect of multiple courses of hyperbaric oxygen（HBO） therapy on the blood coagulation function in patients. Methods 27 patients were in hospital for long-term HBO therapy. Parameters of coagulating status were analyzed retrospectively, including platelet （PLT） count, prothrombin time （PT） ,prothrombin time activity,activated partial thromboplastin time（APTT） and fibrinogen. All patients were tested for coagulating status before HBO therapy. Among them, 16 cases were tested after the 3rd courses, 14 cases after the 5th courses,9 cases after the 7th courses, 13 cases after the 8th courses and 16 cases after the 10th courses. Results PLT count significantly decreased after the 3rd course （ P 〈 0.01 ） and the 8th course HBO therapy（ P 〈0.05 ）. After HBO therapy, PT did not change, compared with that before HBO therapy, except after the 5th course （ P 〈 0.05 ）. After the 3rd （ P 〈 0.05 ） and the 10th course （ P 〈 0.01 ） HBO therapy, the levels of FIB decreased ,compared with those before the HBO therapy. After HBO therapy the levels of prothrombin time activity and APTr did not change significantly at various time points （ P 〉 0.05 ）. Conclusions The multiple courses of HBO therapy did not have significant harmful effect on the blood coagulation function in patiemts.