脑肿瘤患者围手术期纤溶的变化及分析  

Perioperative Analysis of Fibrinolysis Function in Brain Tumor Patients with Craniotomy

作　　者：谢英华[1] 杨秋继[1] 马骏峰 张静[3] 赵莉敏[1,3] 陆莹婷 韩曦瑶[1] 李文刚 刘立根[1,3] XIE Ying-hua;YANG Qiu-ji;LIU Li-gen(Department of Hematology,shanghai Fifth People’s Hospital,Fudan University,Shanghai,200240,China)

机构地区：[1]复旦大学附属上海市第五人民医院血液内科,上海200240 [2]复旦大学附属上海市第五人民医院神经外科,上海200240 [3]上海交通大学医学院附属同仁医院血液科,上海200336

出　　处：《血栓与止血学》2019年第5期721-724,共4页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的观察脑肿瘤患者围手术期纤维蛋白溶解(纤溶)指标的变化,探讨其变化规律。方法检测22例脑肿瘤患者开颅手术前及术后第1、3、7天凝血酶时间(TT)、纤维蛋白原(Fbg)、D二聚体(D-D)及凝血酶激活的纤溶抑制物(TAFI)浓度,并与健康对照组进行比较。结果脑肿瘤患者术前血浆D-D含量、低纤维蛋白原血症发生率较健康对照组升高(P<0.05),差异有统计学意义,两组TT、TAFI浓度术前均无显著差异(P>0.05)。开颅术后第1天与术前相比,血浆FIB水平、TAFI浓度下降(P<0.05),D-D含量升高(P<0.05),差异均有统计学意义,TT无显著差异(P>0.05)。脑肿瘤患者开颅术前低纤维蛋白原血症发生率为22.73%,术后第1天低纤维蛋白原血症发生率为81.82%。结论脑肿瘤患者有较高低纤维蛋白原血症发生率,开颅手术增加其发生率,发生机制可能与TAFI水平降低有关。Objective To observe the change of the relevant indicators of fibrinolysis in brain tumor patients in perioperative,and discuss the rule of its change.Methods Measured the thrombin time(TT),fibrinogen(Fbg),D-dimer(D-D)and thrombin-activatable fibrinolysis inhibitor(TAFI)level of 22 brain tumor patients at the preoperation and postoperation 1,3,7 d,then compared with healthy control group.Results Compared with healthy control group,brain tumor patients had higher level of D-D and higher incidence of hypofibrinogenemia(P<0.05)at the preoperation,while TT,TAFI had no significant difference(P>0.05).Brain tumor patients had lower Fbg and TAFI(P<0.05),higher D-D(P<0.05)on the first day of postoperation,while TT had no significant difference(P>0.05).Brain tumor patients with hypofibrinogenemia at the preoperation and the first day of postoperation was 22.73%and 81.82%,respectively.Conclusion Brain tumor patients prone to abnormality of coagulation and fibrinolysis at the preoperation,and craniotomy could further influence the fibrinolytic system.

关 键 词：脑肿瘤 开颅术 凝血酶激活的纤溶抑制物 

分 类 号：R739.41[医药卫生—肿瘤]