胆囊围手术期FBG、APTT、PT变化研究

Changes in fibrinogen,activated partial thromboplastin time,prothrombin time in patients during perioperative period of cholecystectomy

目的:动态观察纤维蛋白原(FBG)、活化部分凝血活酶时间(APTT)及凝血酶原时间(PT)在围胆囊手术期的变化及机理。方法:将30例胆囊结石欲行胆囊切除术的患者分为术前、术中及术后即刻共3组,分别比较FBG、APTT、PT的变化。结果:纤维蛋白原术中与术前,术后与术中,术后与术前相比均呈阶段性减少,差异有统计学意义(P<0.01)。活化部分凝血活酶时间,术中与术前及术后比较差异均无统计学意义(均P>0.05),术后与术前比较差异有统计学意义(P<0.05)。凝血酶原时间的INR值,术前、术中、术后差异均无统计学意义(均P>0.05)。结论:纤维蛋白原可被麻醉及手术创伤所影响呈减少趋势,APTT不受麻醉影响,但可受手术创伤影响而致时间缩短。PT则不受手术及麻醉的影响。

Objective： To observe the changes and mechanisms of fibrinogen （FBG）, activated partial thromboplastin time （APTT）, prothrombin time （PT） in patients during preoperative period of cholecystectomy. Methods：Thirty cholecystolithiasis patients who were scheduled to undergo cholecystectomy were divided into perioperative, intraoperative and postoperative groups. The changes of FBG, APTT, PT were compared among the three groups. Results：Decreases in FBG was significantly different among the three groups （P〈0.01）. No significant difference in APTT was found between intraoperative and preoperative group （P〉0.05）, but changes was significant different between postoperative group and preoperative group （P〈0.05）. No significant difference in INR value was found among the three groups. Conclusions：The content of FBG could be affected due to influence of anesthesia and surgical wound, APTT could be shortened by surgical wound but not anesthesia, while PT can be affected by neither anesthesia nor surgical wound.