重型肝炎肝移植手术患者围术期凝血功能的观察及护理

Observation and Nursing of Perioperative Blood Coagulation Functionin Patients With Severe Hepatitis After Liver Transplantation

目的研究重型肝炎肝移植手术患者围术期凝血功能的情况,对其进行护理和观察。方法从2013年2月-2016年2月我院收治的重型肝炎肝移植手术患者中选取12例,用抽血测定方式检测重型肝炎肝移植手术患者围术期凝血酶时间、血小板计数、活化部分凝血活酶时间、纤溶酶活性等指标以及在手术前、手术后、无肝、新肝5 min、新肝3 h不同阶段的情况。结果相比较手术前,凝血物质应用之后,术后纤溶酶活性下降,无肝时改善凝血酶时间,血小板计数、活化部分凝血活酶时间也降低。结论重型肝炎肝移植手术患者围术期凝血情况十分复杂,护理人员对患者术中血小板量、出血情况进行统计,监测使用凝血物质之后凝血功能的改变状态,确保能够顺利完成手术。

Objective To study the perioperative blood coagulation function in patients with severe hepatitis after liver transplantation. Methods 12 cases of severe hepatitis with liver transplantation in our hospital from February 2013 to February 2016 were selected, determination methods for detection of severe hepatitis patients in the perioperative period of liver transplantation, platelet count, prothrombin time activated partial thromboplastin time, fibrinolytic activity and other indicators as well as before and after surgery, news liver of 5 min, 3 hours in different stages of blood. Results Compared to before the surgery, after the application of anticoagulants, decreased fibrinolytic activity after operation, improve the thrombin time without liver, platelet count, activated partial thromboplastin time was also reduced. Conclusion Severe hepatitis liver transplant patients in the perioperative period of coagulation is very complex. The nursing staff statistics on platelet in patients with bleeding, and change the state of blood coagulation after use of anticoagulants monitoring, to ensure successful completion of surgery.