体外循环对血小板计数及释放反应的影响  

Effects of cardiopuimonary bypass on platelet counts and platelet release reaction

作　　者：张诗海[1] 曾邦雄[1] 

机构地区：[1]同济医科大学附属协和医院麻醉科,武汉430022

出　　处：《中华麻醉学杂志》1998年第8期457-459,共3页Chinese Journal of Anesthesiology

摘　　要：目的：探讨体外循环（ＣＰＢ）对血小板计数及血小板释放反应的影响。方法：２０例ＣＰＢ患者分别于转流前、转流３０分、鱼精蛋白中和肝素后１０分及术后２、１２和２４小时进行血小板计数（ＢＰＣ）、血小板表面α颗粒膜蛋白（ＧＭＰ－１４０）、血小板β球蛋白（β－ＴＧ）、血小板第４因子（ＰＥ４）及５－羟色胺（５－ＨＴ）的测定，并统计术后显著出血的例数。结果：ＢＰＣ在转流期间显著下降，但仍高于５０×１０＾９／Ｌ。To investigate the effects of cardiopulmonary bypass (CPB)on the aquired platelet damage and the relationship between the aquired platelet damage and non-surgical postoperative bleeding. Method: Platelet counts (BPC), alphagranule membrane protein (GMP-140), β-thromboglobulin (β-TG), platelet factor 4 (PF_4), and 5-hydrooxytryptamine levels were measured in 20 patients undergoing cardiac surgery before CPB, 30 min during CPB, 10 min after CPB, and 2, 12, and 24 hours postoperatively. The numbers of patients with bleeding volume over 200 ml within 24 hours postoperatively were counted. Result: BPC decreased markedly during CPB, but never decreased to the degree of 50×10~9/L. GMP-140, β-TG, PF_4 and 5-HT levels were significantly increased during CPB until 12 hours postoperatively. Eight patients(40%) got the bleeding volume over 200 ml within 24 hours postoperatively. Conclusion: Platelet release reaction is violent during cardiac surgery with CPB. A large number of platelets dysfunctioned because of granula releasing or damage may be the main cause of non-surgical postoperative bleeding.

关 键 词：心肺转流术 血小板计数 释放反应 体外循环 

分 类 号：R654.1[医药卫生—外科学]