心肺转流对凝血及血小板功能的影响  

Effect of Cardiopulmonary Bypass on Coagulation and Platelet function

作　　者：周萍[1] 陆静[1] 姜萍[1] 

机构地区：[1]广东医学院附属医院,广东湛江524001

出　　处：《湖北民族学院学报（医学版）》2008年第1期37-38,共2页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的应用Sonoclot凝血及血小板功能分析仪检测心脏手术心肺转流对血小板功能的影响。方法麻醉前病情分级ASAI一Ⅲ级，心脏手术患者30例，其中瓣膜置换术18例、室缺修补术12例。采用静吸复合全身麻醉，分别于麻醉诱导后（T1）、肝素化后10min（3mg／kg）（T2）、CPB后10min（T3）及鱼精蛋白拮抗后10min（T4）抽血，检测激活全血凝固时间（sonACT）、凝血速率（clotrate）和血小板功能并进行血小板计数。结果与T1相比，T2点的凝血速率及sonACT明显升高（P〈0．01），血小板计数和血小板功能降低（P〈0．05）；13点的sonACT明显延长，凝血速率和血小板功能显著下降，血小板计数明显降低（P〈0．01）；T4点的sonACT明显延长、血小板功能明显升高（P〈0．01），凝血速率无明显变化，血小板计数显著降低（P〈0．01）。结论心肺转流可显著影响血小板功能，心脏手术中监测凝血及血小板功能有重要的临床意义。Objective To study the effect of cardiopulmonary bypass on coagulation and platelet function using Sonoclot coagulation and platelet function analyzer. Melees 30 patients graded ASA I - Ⅲ were designed in this study, in which 18 patients underwent valve replacement and other 12 patients underwent ventricular septal defect surgery. All cases were anesthetized with combined anesthesia. The SonACT, clot rate, platelet function and platelet count were measured after induction of anesthesia（T1）,10 minutes after heparinization（T2）, 10 minutes after CPB（T3） and 10 minutes after protamine administration（T4）respectively. Reselts Compared with at T1 ,the clot rate and sonACT were higher, platelet count and platelet function was lower at T2,the sonACT was significantly prolonged, the clot rate, platelet function and platelet count were markedly reduced at T3, the sonACT was significantly prolonged and platelet function was higher and platelet count were markedly reduced at T4. Conclusions CPB can affect platelet function and it is important to monitor coagulation and platelet function during cardiac surgery.

关 键 词：心肺转流术 血小板功能 血液凝固 

分 类 号：R654.1[医药卫生—外科学]