南海驻岛礁官兵血液流变和凝血分析改变及干预措施

Changes of Hemorrheology and Blood Coagulation Analysis and Intervention Measures for Soldiers Garrisoning on Reef in South China Sea

目的分析南海驻岛礁官兵守礁后血液流变、血凝分析和血细胞指标改变，探讨综合干预措施的作用。方法选择2012年9～12月166名成建制守礁、男性健康官兵为研究对象。其中南海大礁104名官兵为干预组，小礁62名官兵为未干预组。分析守礁前血流变和凝血分析、血细胞指标。结果未干预组守礁后全血低切黏度、全血中切黏度、全血高切黏度、红细胞容积、红细胞变性指数、红细胞聚集指数、红细胞沉降率增高，血浆黏度降低，有统计学差异（P〈0．01或0．05），干预组守礁前后无差异（P〉0．05）；未干预组守礁后凝血酶原时间、部分凝血活酶时间增高，纤维蛋白原、D-二聚体下降，有统计学差异（P〈0．01或0．05），干预组守礁后凝血酶原时间增高（P〈0．05），其它无差异（P〉0．05）；未干预组守礁后红细胞、血小板、血红蛋白、红细胞容积增高，红细胞平均体积下降，有统计学差异（P〈0．01或0．05），干预组守礁前后无差异（P〉0．05）。结论南海驻岛礁官兵守礁后血液、血凝和血细胞指标发生明显改变，综合干预后指标可恢复正常，建议增加维生素K的补充。

Objective To analyse the changes of the hemorrheology, blood coagulation analysis and blood cells indexes of the soldiers after garrison on the reef in the south China sea, and explore the effect of comprehensive intervention measures. Methods A total of 166 male soldiers garrisoning on the reef in the south China sea from September to December, 2012 were studied, among whom 104 soldiers on the big reef in the south China sea were as the intervention group, and 62 soldierson the small reef were as the no intervention group. Hemorrheology, blood coagulation analysis and blood cells indexes were analysed before and after garrison of these soldiers. Results The no intervention group had increased low shear rate of whole blood viscosity, mid shear rate of whole blood viscosity, high shear rate of whole blood viscosityhad,hematocrit, red blood cell degeneration index, red blood cell aggregation index, erythrocyte sedimentation rate and decreased plasma viscosity aftergarrison （P〈0. 05 or 0. 0l）. The intervention group had no significant change in these indexes after garrison （P〈0. 05）. The no intervention group had decreased prothrombin time, activated partial thromboplastin time, fihrinogen and D-Dimer after garrison （P〈0. 05 or 0. 01）. The intervention group had increased prothrombin time （P〈0. 05） and no significant chage in others indexes after garrison （P〉0. 05）. The no intervention group had increased red blood cell, platelet, hemoglobin, hematocrit and decreased mean corpuscular volume after garrison （P〈0. 05 or 0. 01）. The intervention group had no significant change in these indexes after garrison （P〈0. 05）. Conclusion The hemorrheology, blood coagulation and blood cells indexes of the soldiers change significantly after garrison on the reef in the south China sea and can returne to normal after comprehensive intervention. It is suggested to increase the supplement of vitamin K.