重度失血性休克后凝血机制的异常改变及原因分析(PDF)
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2005年第5期
- 页码:
- 464-467
- 栏目:
- 临床研究
- 出版日期:
- 2005-10-05
文章信息/Info
- Title:
- Changes in coagulation properties in patients with severe hemorrhagic shock
- Author(s):
- HOU Lichao; XIONG Lize; CHEN Shaoyang; HU Wenneng; ZHU Xiaoling
- Department of Anesthesiology and Critical Care, Xijing Hospital, Fourth Military Medical University, Xi′an,Shaanxi 710032 China
- 分类号:
- R614;R554
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 观察分析重度失血性休克后凝血机制的变化及其处理。方法 重度失血性休克患者17例，给予生命体征监测，观察其全身及手术伤口局部出血情况，定时抽取血样做血常规、肝肾功能及凝血功能测定，对符合凝血功能障碍诊断标准者均给予输血及补充凝血因子、止血及积极治疗原发病等处理。结果 所有患者均在休克后发生全身多处出血或渗血；血红蛋白显著低于正常值，血小板明显减少；转氨酶异常升高；凝血酶原时间（PT）、活化部分凝血活酶时间（APTT） 时间延长，国际标准化比值（INR）显著高于正常值，凝血酶原活动度（AT）显著低于正常值（与正常值比较，均P<0.01）。所有患者经过治疗后，出血现象均得到控制，凝血机制相关指标均恢复正常或接近正常范围（与治疗前比较，均P<0.05或P<0.01），同时转氨酶也有显著下降（与治疗前比较，均P<0.01）。结论 重度失血性休克后均可能发生凝血功能障碍，经及时给予输血、补充凝血因子、止血及原发病治疗后，均可得到有效的控制。
- Abstract:
- AIM To observe and analyse abnormal changes in coagulation mechanism after severe hemorrhagic shock. METHODS Seventeen patients with severe hemorrhagic shock admitted to our department were included in this study under continuous obsevation for at least 7 days. During the observation period, blood test, liver and kidney function test and coagulation function test were done everyday. All patients were given blood transfusion, supplement of coagulation factors, hemostasis and the treatment of primary diseases as needed. RESULTS Bleeding occurred to all patients after severe hemorrhagic shock. And the results from laboratory examinations revealed marked decrease in blood hemoglobin and thrombocytopenia, extreme abnormal increases of liver aminotranferase, the abnormal PT, INR and APTT, and decrease of AT in all the patients（P<0.01 vs normal value）. After the treatment, bleeding ceased in all patients, and the above-mentioned coagulation related factors and aminotransferases returned to normal levels（P<0.05 or P<0.01 vs that before treatment）. CONCLUSION The disturbance in coagulation mechanism could occur in all patients with post hemorrhagic shock. Blood transfusion, supplement of coagulation factors, hemostasis and the treatment of primary diseases should be timely performed for the effective correction of coagulation dysfunction.
参考文献/References
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备注/Memo
- 备注/Memo:
- 收稿日期：2004-07-27.
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