ABO血型因素对硬膜外麻醉病人围术期凝血功能的影响  

Effects of ABO blood group factors on perioperative coagulation in patients following epidural anesthesia

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,呼和浩特市010050

出　　处：《中华麻醉学杂志》2013年第4期409-412,共4页Chinese Journal of Anesthesiology

基　　金：内蒙古自然科学基金（2010MS1142）

摘　　要：目的评价ABO血型因素对硬膜外麻醉病人围术期凝血功能的影响。方法硬膜外麻醉下行择期小出血量手术病人120例，ASA分级Ⅰ或Ⅱ级，性别不限，年龄30～50岁，体重50～75kg，按照ABO血型分为4组（n=30）：A型血组（A组）、B型血组（B组）、AB型血组（AB组）和O型血组（O组）。于麻醉前（T1）、手术30min（T2）、术毕（T3）、术后1h（T4）、8h（T5）和24h（T5）时采集中心静脉血，测定PT、APTT、Fib浓度、凝血酶时间（TT）、凝血酶原活动度（PTA）、Hct和P1t计数。结果T1-6 时各组凝血功能指标均在正常范围。与T1时相比，T2-6时O组血浆Fib浓度降低，PTT、TT和APTT延长（P〈0．05），A组、B组及AB组各项指标差异无统计学意义（P〉0．05）。与A组、B组及AB组相比，T1-6时O组Fib浓度降低，PT、TT和APTT延长（P〈0．05或0．01）。结论虽然不同血型病人硬膜外麻醉下围术期凝血功能均维持在正常范围，但相对于其他血型，O型血病人凝血功能降低。Objective To evaluate the effects of ABO blood group factors on perioperative coagulation in patients following epidural anesthesia. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients, aged 30-50 yr, weighing 50-75 kg, scheduled for elective operations expected to cause small volume of blood loss during operation under epidural anesthesia, were divided into 4 groups according to the blood group （ n = 30 each） ： blood group A group （A group）, blood group B group （B group）, blood group AB group （AB group） and blood group 0 group （O group）. Blood samples were taken from the central vein before anesthesia （baseline, T1 ）, at 30 min after be- ginning of operation （T2 ） , at the end of operation （T3 ）, and at 1, 8 and 24 h after operation （ T4-6 ） for determina- tion of prothrombin time （ PT）, activated partial thromboplastin time （ APTT）, fibrinogen （Fib） concentration, thrombin time （Tr）, prothrombin activity （PTA）, hematocfit （Hct）, and platelet （Plt） count. Results The pa- rameters of coagulation were within the normal range at T1-6 in each group. Compared with the baseline value at T1 , Fib concentration was significantly decreased, and PT, TT and APTT were increased at T2-6 in O group （ P 〈 0.05）, however, no significant change in all parameters was found at T2-6 in the other three groups （ P 〉 0.05）. Fib concentration was significantly lower, and PT, APTF and TF were longer at T1-6 in O group than in A, B and AB groups （ P 〈 0.05 or 0.01 ）. Conclusion Although perioperative coagulation is in the normal range under epi- dural anesthesia in patients of different ABO blood groups, the coagulation is decreased in patients of blood group Oas compared with the other blood groups.

关 键 词：ABO血型系统 麻醉 硬膜外 血液凝固试验 

分 类 号：R614[医药卫生—麻醉学]