脾切除术后凝血机制的变化对骨折手术治疗的影响

Effect of abnormal blood coagulation after splenectomy in surgical treatment of fractures in fracture patients with splenic rupture

目的探讨骨折合并脾破裂的患者,脾脏切除术后凝血功能的异常对骨折治疗的影响。方法脾切除术后,严密监测凝血功能,尤其是纤维蛋白原(Fbg)和D-二聚体(D-Dimer)及血小板的变化。结果骨折合并脾破裂的患者,脾切除后,多数会出现高凝状态,表现为血小板数量升高,纤维蛋白原和D-二聚体阳性而影响骨折的治疗。结论骨折合并脾破裂的患者,脾切除术后,多数会出现高凝状态,必须动态监测凝血功能,主要是血小板,Fbg及D-Dimer,必要时给予药物治疗,以防止血栓形成而影响骨折的手术治疗。

Objective To study the effect of abnormal blood coagulation after splenectomy in sur- gical treatment of fractures in fracture patients with splenic rupture. Methods Blood coagulation closely after splenectomy were monitored, especially the change of fibrinogen （Fbg） and d：dimer （D） and platelet. Results Most blood oS fracture patients with splenic rupture was hypercoagulability which im- pacts the treatment of fraeturs,because their blood shown that the number of platelet arises fibrinogen and d-dimer were positive. Conclusion The blood of most fracture patients with splenic rupture is hy- percoagulability after splenectomy, therefore, the function of coagulation must be dynamic monitored especially Platelets, Fbg, and D-Dimer. Using drug timely to avoid thrombus affects the surgical treatment of fractures.