高原世居者至平原后HR、FIB、PLT的改变及对颅脑手术的潜在影响  

Changes of HR,FIB and PLT of the plateau natives to plains and the potential effect on craniocerebral surgery

作　　者：罗强[1] 刘卫平[1] 韩福新[1] 阳昊[1] 伊西才[1] 刘远杨[1] 汪凯[1] 贾晨光[1] 樊才瑞 

机构地区：[1]第四军医大学西京医院神经外科,陕西西安710032

出　　处：《中华神经外科疾病研究杂志》2014年第3期228-231,共4页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的分析高原世居者至平原后心率(HR)、血浆纤维蛋白原含量(FIB)及血小板参数的改变,可以为高原脱适应改变提供一些理论依据,也可为高原颅脑疾病患者至平原后手术时机的选择及麻醉围术期的治疗和护理提供一些重要的理论支持。方法选择于2012年11月来我院的西藏阿里地区(平均海拔4 500 m)的患者家属12人作为观察对象,来我院体检中心且通过健康体检的年龄、性别比例、工作性质等因素与观察组大致相同的12名本地人(平均海拔400 m)作为对照组,在观察组到达后2 d分别对两组进行心电图,血常规,凝血功能检查。结果与对照组相比,观察组HR和血小板(PLT)显著降低(P<0.01),FIB水平显著升高(P<0.01),血小板分布宽度(PDW)、平均血小板体积(MPV)的差异无统计学意义(P>0.05),大血小板比率(P-LCR)增加(P<0.05)。结论高原世居者至平原后HR、PLT、FIB与对照组比较发生显著改变,应作为脱适应期改变的监测指标,在处理来自高原地区的颅脑疾病患者,尤其是需要手术者应高度关注这些指标的改变。Objective The changes of heart rate （HR）,platelet parameters and fibrinogen （FIB） of the plateau natives who go to plain are analyzed to provide theoretical basis for changes of plateau deadaptation and provide some important parameters for the choice of the timing of surgery and perioperative anesthetic treatment and nursing.Methods Twelve observation objects were included,who are family members of patients from Ali Tibet （an average altitude of 4 500 m） to Xijing Hospital in November 2012.Twelve healthy locals （an average altitude of 400 m） were enrolled in this study as the control group,who were similar in age,gender proportion,and occupation.All the patients were examined with electrocardiogram （ECG）,blood routine,and blood coagulation.Results HR and platelet （PLT） levels were significantly decreaesd in observation group compared with the control group （P〈 0.01）,while FIB levels were significantly increased （P 〈 0.01）.No significant difference in platelet distribution width （PDW） and mean platelet volume （MPV） was observed between two groups （P〉 0.05）.But platelet ratio （P-LCR） was increased （P 〈 O.05）.Conclusion The HR,PLT,and FIB of the plateau natives who come to plain will be significantly changed,which could be the monitoring indicators during the deadaptation.All the indices should be paid attention to for the treatment of patients from the plateau region,particularly those who need the surgery.

关 键 词：高原世居者 心率 血小板参数 纤维蛋白原含量 

分 类 号：R594[医药卫生—内科学] R651[医药卫生—临床医学]