|本期目录/Table of Contents|

[1]温超轮,扶晓明,谭雄进,等.糖尿病患者脊柱手术前后凝血状态的变化[J].慢性病学杂志,2018,(6):701-703.
　WEN Chao-lun,FU Xiao-ming,TAN Xiong-jin,et al.Change of coagulation state before and after spinal surgery in patients with diabetes mellitus[J].,2018,(6):701-703.
点击复制

糖尿病患者脊柱手术前后凝血状态的变化(PDF)

《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:
期数:
2018年6期
页码:
701-703
栏目:
论　著
出版日期:
2018-06-27

文章信息/Info

Title:
Change of coagulation state before and after spinal surgery in patients with diabetes mellitus
作者:
温超轮;  扶晓明;  谭雄进;  朱志勇;  阳海波;  蒋飞龙;  曾昭池
中国人民解放军第一六九中心医院骨科，湖南衡阳421002
Author(s):
WEN Chao-lun;  FU Xiao-ming;  TAN Xiong-jin;  ZHU Zhi-yong;  YANG Hai-bo;  JIANG Fei-long;  ZENG Zhao-chi
Department of Orthopedics, the People 's Liberation Army No.169 Central Hospital, Hengyang Hunan 421002, China Corresponding author: ZENG Zhao-chi, E-mail: wss7201@163.com
关键词:
糖尿病; 脊柱手术; 凝血状态
Keywords:
Diabetes mellitus;  Spinal surgery;  Coagulation state
分类号:
R681.5
DOI:
-
摘要:
目的探讨糖尿病患者在脊柱手术前后凝血状态的变化，为临床治疗提供参考。方法选取2016年2月 —2017 年10月中国人民解放军第一六九中心医院收治的70例接受脊柱手术患者，将合并糖尿病史的40例患者作 为观察组，无糖尿病史的30 例患者作为对照组，分别在手术前后采用全血复钙法检测患者血液指标α 角（ANGLE） 、血栓最大幅度（MA）、凝血综合指数（CI）、K 时间、R 时间、纤维蛋白原（Fib）、凝血酶原时间 （PT）、活化部分凝血酶时间（APTT）、血小板计数（PLT），分析其凝血状态变化。结果术前，观察组 ANGLE、MA、CI 明显大于对照组的，K 时间短于对照组的，Fib 高于对照组的（P＜0.05）；观察组术后第 1、3、7 天ANGLE、MA、CI 较对照组显著增大，K 时间缩短，Fib 升高（P＜0.05）；术后第1、3、7 天观察组 ANGLE、MA 与本组术前比较明显增大，R、K 时间缩短，Fib 升高（P＜0.05）；术后第1、3、7 天，对照组 ANGLE、MA、CI 与本次术前比较明显增大，K 时间缩短，Fib 升高，术后第7 天CI 较第3 天降低（P＜0.05）； 组间手术前后PT、PLT、APTT 比较均无明显差异（P＞0.05）。结论脊柱手术能使本已经存在的血液高凝状 态进一步加重，Fib水平可增加凝血块形成速率及最大强度。
Abstract:
Objective To investigate the change of coagulation state before and after spinal surgery in patients with diabetes mellitus and provide evidences for clinical treatment. Methods 70 patients received spinal surgery in the People's Liberation Army No.169 Central Hospital from February, 2016 to October, 2017 were selected, and 40 cases with history of diabetes were included into the observation group, 30 cases of patients without history of diabetes were included into the control group. The blood index alpha angle （ANGLE） , maximum thrombus （MA） , coagulation index （CI） , K time, R time, fibrinogen （Fib） , prothrombin time （PT） , activated partial thromboplastin time （APTT） and platelet count （PLT） of patients were detected by the whole blood calcium recovery method before and after the operation, and the changes of coagulation state were analyzed. Results Before the operation, ANGLE, MA and CI in the observation group were significantly increased than those in the control group, the K time was shortened and Fib was increased （P<0.05） . After 1, 3, 7 days of the operation, ANGLE, MA and CI in the observation group were significantly higher than those in the control group, and the K time was shortened and Fib was increased （P<0.05） . After 1, 3, 7 days of the operation, ANGLE and MA in the observation group were higher than those before the operation, and R and K time were shortened, and the Fib was increased （P<0.05） ; ANGLE, MA and CI in the control group were higher than those before the operation, and K time was shortened,and Fib was increased, and CI after 7 days of the operation was lower than that after 3 days of the operation （P<0.05） . There were no significant differences in PT, PLT and APTT before and after the operation between the two groups （P>0.05） . Conclusion The spinal surgery can make the already existing hypercoagulable state of the blood further aggravated, and the fibrinogen levels can increase the formation rate and maximum intensity of clots.

参考文献/References:

[1] 李刚建,赵鑫. 脊柱手术发生下肢静脉血栓的相关危险因素Logistic 回归分析[J].海南医学,2015,21(5):658-660. [2] 赵亚洲. 浅谈脊柱外科手术并发症及其预防[J]. 临床医药文献电 子杂志,2016,3(34):6779. [3] 岳志丰,陈继营,柴伟,等. 脊柱手术后并发下肢深静脉血栓的影 响因素分析[J]. 中华临床医师杂志(电子版),2013,34(13):5840- 5843. [4] 杨利勇,马海港,李振,等. 老年人脊柱手术后深静脉血栓的诊断 与预防[J].中国组织工程研究,2017,21(23):3694-3699. [5] 谢琴.脊柱手术后下肢深静脉血栓形成危险因素分析及护理干预 [J].饮食保健,2016,3(18):163. [6] 肖辉标.健脾益肾祛淤汤治疗早期糖尿病肾病的临床观察及对凝 血功能影响[J].慢性病学杂志,2016(9):1030-1032. [7] 李彬,陈晓亮,马进峰,等. 糖尿病患者脊柱手术前后凝血状态的 变化[J].中国骨与关节杂志,2013,21(2):70-74. [8] 李延广,李娟,卫奕,等.糖尿病患者凝血状态及影响因素研究[J]. 中华老年心脑血管病杂志,2015,17(5):485-487. [9] 蒋知云,马俊芬,王倩,等. 血栓弹力图预测静脉血栓栓塞症发生 的价值分析[J].中国实验血液学杂志,2017,25(5):1498-1503. [10] 谭延国,张岩,王芳,等.TEG 血栓弹力图同常规凝血试验的关系 及TEG 血小板图试验的临床应用[J].中国实验诊断学,2012,16 (1):81-85.

备注/Memo

备注/Memo:
作者简介：温超轮，硕士，主治医师，研究方向：脊柱外科 通讯作者：曾昭池，E-mail：wcc7201@163.com
更新日期/Last Update: 2018-06-28