颅内肿瘤患者围手术期凝血功能和血常规变化分析  

Analysis of perioperative coagulation function and blood routine changes in patients with intracranial tumors

作　　者：朱字 陈琼[2] 王懿春[2] ZHU Zi;CHEN Qiong;WANG Yi-chun(Medical School of University of South China,Hunan Hengyang 421001,China;Intensive Medicine Department of Hunan Cancer Hospital,Hunan Changsha 410013,China)

机构地区：[1]南华大学医学院,湖南衡阳421001 [2]湖南省肿瘤医院重症医学科,湖南长沙410013

出　　处：《中西医结合心血管病电子杂志》2018年第7期180-182,共3页Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine

基　　金：湖南省科技厅项目(编号:2013FJ3126);湖南省肿瘤医院科研平台项目(编号:PT2013-09);湖南省肿瘤医院青年基金项目(编号:B2012-03)

摘　　要：目的比较开颅与非开颅肿瘤患者手术前后凝血功能和血常规的变化。方法收集我院需手术切除肿瘤的患者90例,按照手术方式不同,分为开颅手术组(Craniotomy group)(研究组)和非开颅手术组(Non-craniotomy group)(对照组)。比较两组患者术前和术后凝血功能:凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、血清D-D二聚体和血常规:血红蛋白浓度(HGB)、红细胞压积(HCT)、血小板(PLT)各项指标水平。结果开颅手术后的肿瘤患者活化部分凝血酶原时间(APTT)术后是降低趋势,凝血酶时间(TT)和纤维蛋白原(FIB)也呈现下降趋势,而血清D-D二聚体呈明显升高,较之前平均升高6.43倍,非开颅手术组平均升高3.24倍,开颅手术病人血清D-D二聚体升高更明显。结论开颅手术对肿瘤患者的凝血功能有影响,凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)明显延长,血清D-D二聚体明显升高,因此,开颅手术后的肿瘤患者,术后血液更高凝,发生栓塞风险更大。Objective To compare the changes of coagulation function and blood routine before and after operation in patients with craniotomy and non-craniotomy.Methods A total of 90 patients were divided into two groups:Craniotomy group(study group)and non-craniotomy group(control group).The coagulation function and blood routine indexes before and after operation were compared between the two groups.Results After craniotomy,activated partial prothrombin time(APTT)decreased,thrombin time(TT)and fibrinogen(FIBs)decreased,and serum D-D dimer increased significantly(6.43 times higher than before).Conclusion Craniotomy has an effect on the coagulation function of tumor patients.Thrombin prothrombin time(PTT),activated partial prothrombin time(APTT),thrombin time(TT)and serum D-D dimer were significantly prolonged and serum D-D dimer was increased after craniotomy.Postoperative blood coagulation is higher and the risk of embolization is higher.

关 键 词：肿瘤 开颅手术 非开颅手术 凝血功能 血常规 血清D-D二聚体 活化部分凝血酶原时间 

分 类 号：R473.73[医药卫生—护理学]