肝硬化并发胆石症术中出血的防治

The Prevention of Hemorrhage During Operation on Cholelithiasis Complicated with Liver Cirrhosis

目的 :探讨肝硬化并发胆石症术中出血的原因 ,寻找预防和处理的方法。方法 :回顾分析46例肝硬化并发胆石症的治疗情况。结果 :9例肝功ChildC级术中出血量平均1704ml;12例凝血酶原时间超过正常对照5s ,出血量平均1150ml。8例术前血浆白蛋白<3 0g/L,出血量平均1736ml;6例血浆胆红素<59 85mol/L出血量平均167ml。结论 :术中出血与肝硬化病理基础有关 ,术前肝功能Child分级、凝血酶原时间、血浆白蛋白、血浆胆红素是评价手术危险性的主要因素 ,积极的术前准备。

Objective:To explore the cause of hemorrhage during the operation o n cholelithiasis complicated with liver cirrhosis,and to discover the ways to prev ent and control such an hemorrhage.Methods:To analyze the treatment processes of 46 recorded cases of cholelithiasis complicated with liver cirrhosis.Results:9 cases which liver function is classified as Child C average blood hemorrhage vol ume is 1704ml,the thrombogen,time of 12 cases surpsasses the normal comparative sample by 5 seconds and the average hemorrhage volume is 1150ml.8 cases had plas ma albumin <3 0g/L,and the average hemorrhage volume is 173ml.6 cases had plasm a bilirubin <59 85mol/L,and the average hemorrhage is 167ml.Conclusion:The hemo rrhage is related with pathological condition of liver cirrhosis.The main factor s of the operation risk consist of Child liver function classification.thromboge n time,plasma albumin,and plasma bilirubin.So positive pre-operation preparatio n and proper operation methods can reduce the hemorrhage volume.