严重肝损伤围手术期纠正凝血功能障碍67例分析  

Adjustment of coagulation during perioperative period of severe liver injury

作　　者：穆振国[1] 曹广涛[1] 王新伟[1] 王海水[1] 郭见光 

机构地区：[1]日照市中医医院普外科,山东日照276800

出　　处：《创伤外科杂志》2009年第4期320-322,共3页Journal of Traumatic Surgery

摘　　要：目的探讨纠正严重肝损伤围手术期凝血功能障碍的方法。方法回顾性分析2001年8月～2008年7月收治的67例Ⅲ～Ⅵ级肝外伤患者，按术前、术中、术后不同比例输注全血、浓缩红细胞、血浆、新鲜血小板、冷沉淀、凝血酶原复合物和纤维蛋白原；配合注射立止血、纠正低体温、纠正酸碱中毒、纠正低钙血症等综合措施。结果65例围手术期凝血功能获改善，治愈61例，死亡6例。结论围手术期合理补充血液及凝血因子是提高肝损伤合并大出血救治成功率的重要措施。Objective To discuss the methods of adjusting coagulation during perioperative period of severe liver injury. Methods The clinical data of 67 cases of severe liver injury（ AAST： grade Ⅲ to Ⅵ） from Aug. 2001 to Jul. 2008 were analyzed retrospectively. Different proportion of WHB（ whole human blood）, CRC （concentrated red cell）, blood plasma, fresh platelet, cryopreeipitate, PTC （ prothrombin complex）, and fibrinogen were injected during perioperative period with the compositive measures of aprotinin/reptilase injection. Hypothennia, acid base imbalance,hypocalcemia were corrected. Results Positive outcome was observed in 65 cases undergoing adjust- ment of coagulation during perioperative period. The 61 cases were cured,and 6 patients died. Conclusion It is an important measure that complementing blood and coagulation factors reasonably during perioperative period to en- hance the success ratio in the treatment of liver injury with severe bleeding.

关 键 词：肝损伤 凝血功能 手术 

分 类 号：R657.3[医药卫生—外科学]