肝移植病人手术前后凝血与纤溶活性的研究

Study on blood clotting and fibrinolysis before and after liver transplantation.

目的探讨肝移植病人手术前后凝血与纤溶功能的变化。方法对肝移植病人移植手术前和手术后1天、2天、1周、2周、1月、2月的血小板、凝血、抗凝血及纤溶系统活性测定,观察其变化规律。结果终末期肝病病人PT、APTT、TT明显延长,Plt计数、Fg、FⅨ:C、AT-Ⅲ及PLG明显降低,D-Dimer明显升高,行肝移植术后,上述指标逐渐恢复正常。结论肝移植病人作Plt、PT、APTT、TT、Fg、FⅨ:C、AT-Ⅲ、PLG及D-Dimer有助于肝移植手术病人止、凝血功能的监测,也是判断手术预后的指标。

Object To investigate the characteristics of blood clotting and fibrinolysis in the patients received liver transplantation. Methods The platelet number, blood clotting activity, anti- blood clotting and fibrinolysis were measured before liver transplantation and 1 day, 2 days, 1 week, 2 weeks, 1 month, 2 months after liver transplantation. The regularities of those changes were monitored. Results Before liver transplantation, platelet number, Fg, FIX：C, AT- Ⅲ and PLG decreased obviously, PT, APTT and TT prolonged obviously, and the level of D-Dimer increased obviously in the patients with the terminal stage of hepatopathy. All of these items recovered to the normal levels after liver transplantation. Conclusions The measurements of Platelet counting, PT, APTT, TT, Fg, FIX：C, AT-Ⅲ, PLG and D-Dimer is valuable to monitor the changes of haemostasis and blood clotting in the patient received liver transplantation, these indexes may also be estimated for the function in the prognosis of liver transplantation.