脑血管病介入手术患者凝血功能变化及其临床意义

Study on clinical significance and changes in coagulation of cerebrovascular disease patient during intervention

目的探讨脑血管病介入手术患者凝血功能变化及其临床意义。方法选取95例颈动脉支架置入(实验组)患者分别于手术前及术后第1、3、5、7天测定血小板计数(plt)、纤维蛋白原(Fg)、D-二聚体、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)等6项指标水平,并与124例全脑血管造影患者(对照组)进行比较。结果实验组与对照组比较术后Fg、D-二聚体水平差异有统计学意义(P<0.01)。Fg、D-二聚体水平术后第1天达峰值(P<0.01),术后第3天均稍有所下降,术后第7天恢复至术前水平。plt、PT、APTT、TT水平与术前比较差异均无统计学意义。结论颈动脉支架置入后凝血系统被激活,Fg、D-二聚体水平升高,提示患者处于高凝状态,并有继发性纤溶亢进。在反应颈动脉支架成形术后患者凝血纤溶障碍中这些检测指标优于常规凝血象检查。

Objective To study on clinical significance and changes in coagulation of cerebrovascular disease patient during inter- vention. Methods 95 patients undergoing carotid artery stenting were randomly selected （experiment group） ,measured the plt,Fg, DD,PT, APTT and TT at the preoperation and postoperation 1,3,5,7d,and compared with those 124 patients with cerebral angi- ography （control group）. Results Fg and DD were significantly different between experiment group and control group （P〈0.01） Fg and DD of the patients undergoing carotid artery stenting rised and achieved the peak level at the ld of postoperation,desending at 3d of postoperation, returned the preopration level at 7d of postoperation,it was no statistical significance of the level of plt,PT, APTT and TT between the pre and the post opration. Conclusion The coagulation system were activated after carotid artery stent- ing,patients having a hypercoagulable state, Fg and DD significantly rised,and could better reflecting the coagulation-Fgrinolysis system than others conventional coagration.