颅脑手术出血量对凝血功能的影响

Influence of Bleeding Volume on Coagulation Function in Cranial Operation

为了解颅脑手术出血量对机体凝血功能的影响，将全麻下３０例颅脑手术患者分为３组，每组各１０例。Ａ组为对照组，Ｂ组患者术前给予立止血２ｋｕ，Ｃ组术前给予立止血２ｋｕ加６－氨基己酸６～８ｇ。于术前、中、终取静脉血，观察凝血酶原时间（ＰＴ）及国际标准化比值（ＰＴ_(ＩＮＲ)）、活化的部分凝血活酶时间（ＰＴＴ）、凝血酶时间（ＴＴ）及纤维蛋白原（ＦＩＢ）检测值。结果 Ａ组术中、术终的ＰＴ、ＰＴ_(ＩＮＲ)值增加， ＰＴＴ术终、ＴＴ术中值增加，差异有显著性（Ｐ＜０．０５或Ｐ＜０．０１）。Ｂ组与Ｃ组术中及术终各检测值均保持在术前水平（Ｐ＞０．０５）。证明术前常规使用立止血及６－氨基己酸可有效防止凝血功能下降，维持机体凝血功能在正常水平。

To study the influence of bleeding volume on coagulation function in cranial operation, 30 patients receiving general anesthesia were divided randomly into three groups. Group A patients were used as control, group B patients were treated with 2 ku reptilase before operation,group C patients were treated with 2 ku reptilase and 6-8 g 6-aminocaproic add. Venous blood was taken to observe preoperatively, mid-operative and postsoperative prothrombin time(PT),prothrombin time international normal rate(PTINR), partial thromboplastin time(PTT), thrombin time(TT)and fibrinogen(FIB). Group A had an increased mid-operative and postoperative PT, PTINR. Its postoperative PTT and mid-operative TT were also increased. The differences were statistically obvious(P < 0. 05, P < 0. 01 ). In group B and group C, mid-operative and postoperative PT, AFINR, PTT,TT and FIB were not increased significantly. This study showed that routine preoperative reptilase and 6-amin- ocaproic acid could keep the normal coagulation function and prevent it from decreasing.