[1]刘宿,蒋耀光,葛衡江,等.肺癌食管癌开胸手术患者术中凝血功能改变及其临床意义[J].陆军军医大学学报(原第三军医大学学报),2007,29(09):779-781.
 LIU Su,JIANG Yao-guang,GE Heng-jiang,et al.Changes and clinical significance of coagulation function of patients with lung cancer or esophagus cancer in thoracotomy[J].J Amry Med Univ (J Third Mil Med Univ),2007,29(09):779-781.
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肺癌食管癌开胸手术患者术中凝血功能改变及其临床意义
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陆军军医大学学报(原第三军医大学学报)[ISSN:1000-5404/CN:51-1095/R]

卷:
29卷
期数:
2007年第09期
页码:
779-781
栏目:
论著
出版日期:
2007-05-15

文章信息/Info

Title:
Changes and clinical significance of coagulation function of patients with lung cancer or  esophagus cancer in thoracotomy
作者:
刘宿蒋耀光葛衡江唐小唪
第三军医大学大坪医院野战外科研究所:全军胸外科中心,麻醉科
Author(s):
LIU Su JIANG Yao-guang GE Heng-jiang TANG Xiao-feng
Thoracic and Cardiovascular Surgery Research Center,Department of Anesthesiology,  Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing 400042, China
关键词:
肿瘤血高凝状态血栓弹力图
Keywords:
cancer hypercoagulability thrombelastography
分类号:
R552.06; R730.56; R734.2
文献标志码:
A
摘要:
目的      应用血栓弹性描记仪观察肺癌、食管癌开胸手术患者围术期凝血功能的改变。      方法      择期行手术治疗的肺癌患者10例,中段或上段食管癌患者10例,观察麻醉前5 min(T0)、手术开始后1 h(T1)、手术结束后30 min(T2)血栓弹性描记仪参数中反应时间(reaction time, R)、凝血形成时间(clotting time, K)、α角(α angle)和最大振幅(maximum amplitude, MA)等指标的变化。10例健康志愿者为对照组。      结果      与正常对照组相比,肺癌患者和食管癌患者术前R值缩短,相差显著(P<0.05)。肺癌患者T1时间点R值、K值延长,α角和MA减小,与T0比较相差显著(P<0.05),术后T2时间点仍然有MA减小,与T0比较相差显著(P<0.05);肺癌患者与食管癌患者相比在T1时间点R、K延长,α角和MA减小,相差显著(P<0.05),T2时间点α角和MA减小,两组比较相差显著(P<0.05);纤溶指数LY30值在T1、T2时间点与T0比较以及同时间点与食管组比较相差显著(P<0.05)。食管癌患者术中、术后TEG变化与T0比较相差均无显著性(P>0.05),T2时间点CI(coagulation index)值与T0比较相差显著(P<0.05);T1时间点与肺癌组比较,R、K有缩短。      结论      两组恶性肿瘤患者术前可能存在高凝状态,肺癌组患者术中、术后凝血功能逐渐趋于低凝状态,而食管癌组患者术中、术后继续有高凝的趋势。
Abstract:
Objective      To study the coagulation of patients with lung cancer or esophagus cancer in thoracotomy during perioperative period.       Methods      Variables [reaction time (R), clotting time (K), α angle, maximum amplitude (MA)]detected by thrombelastography were measured in 10 cases of lung cancer and 10 cases of upper or median esophagus cancer before anesthesia (T0), at the end of 1 h after operation beginning (T1) and 30 min after operation (T2). The control group consisted of 10 healthy volunteers.       Results      In lung cancer group and esophagus cancer group, R was shorter than control group (P<0.05). R and K were longer, α angle and MA were smaller at T1 than at T0(P<0.05), and MA was smaller at T2 than at T0 in lung cancer group. R and K were longer, α angle and MA were smaller at T1, and α angle and MA were smaller at T2 in lung cancer group than in esophagus group (P<0.05). LY30 (fibrinolysis index) at T1 and T2 was longer in lung cancer group than in esophagus cancer group (P<0.05). CI (coagulation index) was longer at T2 in esophagus cancer group than in lung cancer group (P<0.05).        Conclusion      Patients with lung cancer or esophagus cancer have possibility of hypercoagulability before operation. Coagulability of  lung cancer patients decreased during and after operation, and hypercoagulability of esophagus cancer  patients continued during and after operation.

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更新日期/Last Update: 2008-10-24