摘要
目的观察成人体外膜肺氧合(ECMO)支持治疗期间凝血指标的动态变化。方法 42例成人心脏术后ECMO支持患者,于ECMO建立时,建立24 h及撤机前检测血小板计数。分别在ECMO建立前,ECMO建立1、6、24、48、72 h及撤机前测定全血激活凝血时间(ACT)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)及纤维蛋白原(FIB)等指标。按发生院内死亡将患者分为存活组与死亡组,比较2组各时点上述指标的差异。结果血小板计数在ECMO期间明显下降(P<0.05)。PT、APTT与ECMO前相比均明显延长(P<0.05),纤维蛋白原在ECMO建立后一过性降低,6 h后逐渐升高,撤机前达峰值。结论ECMO支持治疗期间通过激活内外源性凝血途径,导致凝血功能紊乱。
Objective To observe dynamic changes of body coagulation indexes during the supportive treatment of extracorporeal membrane oxygenation（ECMO） in adults. Methods The platelet count of 42 cardiac surgery patients with postoperative ECMO at the beginning of ECMO,24 hours after the establishment of ECMO and before removal were detected. The indexes in activated coagulation time（ACT）,prothrombin time（PT）,activated partial thromboplastin time（APTT） and fibrinogen（FIB） were also tested before the establishment of the ECMO and at the 1sthour,6th,24 th,48th,72 ndhours after the establishment of ECMO and before weaning of the ECMO. In addition,the patients were divided into survival group and death group according to the survival in hospital and the indexes mentioned above were compared between the two groups. Results During the ECMO support,blood platelet count declined significantly（P〈 0. 05）. The PT and APTT were significantly longer after the establishment of ECMO than before（P〈 0. 05）. FIB decreased transiently after the establishment of ECMO,increased after 6 hours,and reached the peak value before the weaning of ECMO. Conclusion Coagulation dysfunction is caused by stimulating exterior and interior coagulation system during the supportive treatment of ECMO.
出处
《实用临床医药杂志》
CAS
2015年第9期9-11,17,共4页
Journal of Clinical Medicine in Practice
基金
教育部博士点基金(20101106110010)
首都临床特色应用研究基金(Z111107058811090)
关键词
体外膜肺氧合
凝血
血小板
extracorporeal membrane oxygenation
coagulation function
platelet
