脾切除术对外伤性脾损伤患者血液流变学指标的影响

目的探讨脾切除术对外伤性脾损伤患者血液流变学指标的影响。方法82例外伤性脾损伤患者,依据脾损伤的AAST分级分为对照组(24例)和观察组(58例),观察组接受脾切除手术,对照组接受保守治疗。比较两组患者在入院0、2、4、6、8天时的血常规及血液流变学指标。结果观察组脾切除术后血小板计数进行性升高,入院6天、8天的血小板计数明显高于对照组(P<0.01)。观察组入院2、4天的全血高切还原粘度明显低于对照组(P<0.01)。观察组入院2天、4天、6天的红细胞电泳指数显著高于对照组(P<0.01)。观察组入院4天、6天、8天的全血高切粘度明显低于对照组(P<0.01)。结论外伤性脾损伤行脾切除术后患者的血液流变学指标存在异常,表现为全血高切粘度、全血高切还原粘度减低,血小板计数、红细胞电泳指数升高。

Objective To investigate the effect of splenectomy on hemorheology in patients with traumatic splenic injury.Methods 82 patients with traumatic splenic injury were divided into control group(n=24)and observation group(n=58)according to the AAST classification of splenic injury.Splenectomy was performed in the observation group,and conservative treatment was performed in the control group.The blood routine and hemorheology indexes of the two groups were compared at 0,2,4,6 and 8 days after admission.Results The platelet count in the observation group increased gradually after splenectomy,and the platelet count at 6 and 8 days after admission was significantly higher than that in the control group(P<0.01).2 and 4 days after admission,the whole blood high shear reducing viscosity of the observation group was significantly lower than that of the control group(P<0.01).The erythrocyte electrophoretic index of observation group was significantly higher than that of control group at 2,4 and 6 days after admission(P<0.01).The whole blood high shear viscosity of the observation group was significantly lower than that of the control group at 4,6 and 8 days after admission(P<0.01).Conclusion After splenectomy for traumatic splenic injury,there are abnormal hemorheological indexes,which are manifested as the whole blood high shear viscosity,the whole blood high shear reducing viscosity,and the increase of platelet count and erythrocyte electrophoresis index.