颅内动脉瘤介入术前血小板功能分析

Analysis of platelet function in patients with aneurysm when inventional operation

目的探讨颅内动脉瘤患者血小板功能的各项指标并分析破裂急性期与未破裂期的差别,以及决策是否在急诊介入手术中应用抗血小板或抗凝药物。方法采用Sonoclot血小板功能检测仪对50例颅内动脉瘤患者进行检测,分为急性自发性蛛网膜下腔出血患者即破裂组25例,未破裂组25例,测量计算凝血曲线的各项指标并进行对比。结果破裂组急性期均出现不同程度的血小板功能降低,与未破裂组相比差别有统计学意义(P<0.05)。破裂组动脉瘤急性期血小板功能低于未破裂组(P<0.05),主要体现在R2和R3这2个曲线段,即纤维蛋白与血小板之间交联后产生的凝血收缩能力,以及进一步凝血收缩到完成的能力,前者低于后者。结论颅内动脉瘤破裂急性期血小板功能低于未破裂者,其介入手术给予肝素化及术后应用抗血小板药时需慎重。

Objective To explore each index of platelet function in patients with intracranial aneurysms and analysis the differences between ruptured when acute case and unruptured,and decide whether using the anti-platelet or anti-coagulation drugs when the emergency interventional operation.Methods Sonoclot platelet function detector was used to detect the platelet function of 50 cases patients catching intracranial aneurysms,included acute spontaneous subarachnoid hemorrhage（SAH） in 25 cases（rupture group） and 25 patients with unruptured aneurysms（unruptured group）,then measured and calculated each indicators of the coagulation curve and compared that.Results The study demonstrated that there was different degree of reduced in platelet function while acute period in rupture group,and had statistical differences compared with unruptured group（P〈0.05）.In other words,the platelet function in rupture group was inferior to which in unruptured group（P〈0.05）,mainly reflecting in coagulation curve R2 and R3 segment,that was to say,the blood coagulation contraction ability after fiber protein and platelet crosslinking and the ability in further coagulation contraction until finished in rupture group was inferior to which in unruptured group.Conclusion The platelet function of acute ruptured intracranial aneurysms is inferior to the unruptured group,it is cautious when administrating the heparin in the emergency interventional operation and anti-platelet drugs in postoperation.