经皮肾镜取石术后肾脏出血患者凝血功能、血小板数量变化及其临床意义

Changes of Coagulation Function and Platelet Countand Their Clinical Significancein Patients with Renal Hemorrhage after Percutaneous Nephrolithotomy

目的观察经皮肾镜取石术后肾脏出血患者凝血功能、血小板数量变化及其临床意义。方法选择我院2015年3月至2018年3月经皮肾镜取石术后肾脏出血患者87例,依次取患者术前、术后治疗前及治疗后(1 d、3 d、5 d)血样进行血常规检查,检测两组患者凝血四项[纤维蛋白原(fibrinogen,Fbg)、凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,aPTT)、凝血酶时间(thrombin time,TT)]及血小板数量变化情况。结果经皮肾镜取石术后肾脏出血患者,术前及术后各时间点Fbg、PT、aPTT、TT、血小板水平变化较大(P<0.05);术后治疗前及治疗后1 d,Fbg、PT、aPTT、TT水平均高于术前、治疗后3 d、5 d(P<0.05);术后治疗前及治疗后1 d,血小板水平低于术前、治疗后3 d、5 d(P<0.05)。结论经皮肾镜取石术后肾脏出血患者术后及治疗后1 d凝血功能、血小板数量变化较大,医护人员应在该时间段加大监护力度,防止因血小板稀释及凝血异常引起的出血,提高肾脏出血治疗效率。

Objective To study the changes of coagulation function and platelet countand their clinical significance in patients with renal hemorrhage after percutaneous nephrolithotomy.Methods 87 patients with renal hemorrhage after percutaneous nephrolithotomyin our hospital from March 2015 to March 2018 were selected.The blood samples were taken for blood routine examination before operation and before and after treatment(1 d,3 d,5 d)after operation.The coagulation four indices[Fibrinogen(Fbg),prothrombin time(PT),activated partial thromboplastin time(aPTT),thrombin time(TT)]and platelet count were detected in the two groups.Results Among patients with renal hemorrhage after percutaneous nephrolithotomy,there were significant changes in the levels of Fbg,PT,aPTT,TT and platelet before operation and at each time point after operation(P<0.05).Before treatment and at 1 d after treatment after operation,the levels of Fbg,PT,aPTT and TT were higher than those before operation and those at 3 d and 5 d after treatment(P<0.05).Before treatment and at 1 d after treatment after operation,the platelet level was lower than that before operation and thatat 3 d and 5 d after treatment(P<0.05).Conclusion There are significant changes in coagulation function and platelet count after operation and at 1 d after treatment in patients with renal hemorrhage after percutaneous nephrolithotomy.Medical staff should increase the monitoring intensity during this period to prevent hemorrhage caused by platelet dilution and abnormal blood coagulation,and to improve the treatment efficiency of renal hemorrhage.