梗阻性黄疸对围术期不同ABO血型病人凝血功能的影响  

The Effects of Obstructive Jaundice on Perioperative Function in the Patients of Different ABO Blood Group

作　　者：于建设[1] 解雅英[1] 吕亮亮[1] 

机构地区：[1]内蒙古医科大学附属医院麻醉科,内蒙古呼和浩特010050

出　　处：《内蒙古医学杂志》2013年第3期257-260,共4页Inner Mongolia Medical Journal

基　　金：内蒙古自然科学基金资助项目2010MS1142

摘　　要：目的:探讨梗阻性黄疸对围术期不同ABO血型病人凝血功能的影响。方法:选择A、B、AB、O型血梗阻性黄疸病人各30例,均采用全麻联合硬膜外麻醉。所有病例均在麻醉前T1、手术开始后30 min T2、60 min T3、手术结束后1 h T4、8 h T5、24 h T6采中心静脉血检测血浆凝血酶原时间(PT)、凝血酶原活动度(PT%)、活化部分凝血活酶时间(Aptt)、血浆纤维蛋白原(Fib)、凝血酶时间(TT)、红血球压积(HCT)、血小板计数(Plt)。手术后统计各组出血量。结果:麻醉前T1,O型血病人Fib、PT%偏低,而PT、TT、Aptt高于其他3种血型,但4种血型病人之间差异无统计学意义。手术中T2、T3时及手术后T4、T5和T6,O型血Fib、PT%更低于其它3种血型(P<0.05),PT、TT、Aptt也更高于A、B、AB血型病人(P<0.05)。4组术后出血量均少于50ml,而且差异无统计学意义。结论:梗阻性黄疸对围术期O型血病人Fib、PT%、PT、TT、Aptt影响明显,使O型血病人凝血功能明显较其它血型病人差。Objective：To study the effects of obstructive jaundice on perioperative coagulative function in patients of different ABO blood group. Mtbods： 120 patients of obstructive jaundice selected according to ABO blood group were divided into four groups（ n = 30）, including A blood group（A group）, B blood group（B group） , AB blood group （AB group） and O blood group （O group）. All patients were anesthetized with general p｜us epidural anesthesia. The blood samples were taken from CVP line before anesthesia （T1） , 30 min after operation （T2） , 60 rain after operation（T3） , 1 h after the end of operation（T4）, 8 h after the end of operation（T5） and 24 h after the end of operation（T6）. The blood samples were collected for determination of PT, PT %, Aptt, Fib, TT, Hct, Ph. Blood lose of all patients were calculated. Results：The Fib and PT% of O group were lower than other three group at T1, but PT, ＂IT, Aptt of O group were longer than other three groups at same time. There were no different among the four group at T1. The Fib and PT% of O group were singnificant lower than A , B and O goup at T2 , T3 , T4 , T5 and T6 （P 〈 0.05）. The PT, TT, Aptt of O group were singnificant longer than other three group at same time（P 〈 0.05）. Conclusion： The effects of obstructive jaundice on perioperative coag- ulation in O blood group is stronger than non-o blood groups.

关 键 词：梗阻性黄疸 围术期病人 ABO血型 凝血功能 

分 类 号：R614.1[医药卫生—麻醉学]