神经外科老年手术患者围手术期凝血功能变化  

The perioperative changes of coagulation function in elderly patients undergoing neurosurgical intervention

作　　者：付惠群[1] 王天龙[1] 

机构地区：[1]首都医科大学宣武医院麻醉科,北京100053

出　　处：《国际麻醉学与复苏杂志》2016年第8期723-726,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：背景手术、老年及神经组织影响老年神经外科手术患者的凝血与纤溶的平衡。血栓弹力图全面监测围手术期凝血与纤溶的变化，有助于维持正常的凝血功能。目的就手术、老年及神经组织对凝血与纤溶的影响和止血机制新观念及凝血与纤溶检测新技术（血栓弹力图）进行综述。内容老年神经外科手术患者凝血功能紊乱，导致围手术期高凝状态，倾向于血栓栓塞。以细胞为基础的止血机制新观念更加准确地阐述了体内止血过程分子机制，同时也促进了临床应用血栓弹力图分析血小板、凝血因子、纤溶功能。趋向这项新技术的使用将能够有效地防止围手术期血栓的形成或出血的发生。Background The balance between coagulation and fibrinolysis is affected by surgical intervention, aging and nerve tissue in elderly patients undergoing neurosurgical procedure. The use of thrombelastography monitors the perioperative changes of coagulation and fibrinolysis and is beneficial for maintaining normal clotting function. Objective This article reviews the effects of surgical procedure, aging and nervous tissue on coagulation and fibrinolysis and the new concept of hernostasis as well as thrombelastography, thenew technology to detect blood coagulation and fibrinolysis. Content Disorder of clotting function in elderly neurosurgical patients results in perioperative hypercoagulable state and tendency for thromboembolism. As a new view the cell-based model of hemostasismore accurately describes the molecular mechanisms of hemostatic process in vivo. It also promotes the clinical application of thrombelastography for assessing the function of platelets, coagulation factors and fibrinolysis in blood. Trend The use of this new technology will effectively prevent perioperative thrombosis or bleeding.

关 键 词：凝血功能 止血机制 血栓弹力图 老年患者 神经外科手术 

分 类 号：R614[医药卫生—麻醉学]