摘要
目的:探讨体内血小板参数变化与兔深静脉导管留置所致的导管相关性血栓(CRT)发生的关系。方法:新西兰大耳白兔随机分为空白对照组、假手术组和置管组。置管组在颈外静脉成功留置静脉导管后分为生理盐水组和甘露醇组,再平均分为留置1、3、5 d 3个时间段。采集各组置管前、后各个时间段的血标本检测血小板参数:血小板计数(PC)、血小板平均体积(MPV)和血小板分布宽度(PDW)。最后一次抽血后处死实验兔,取导管所在血管或同侧颈外静脉制作病理标本观察血栓形成情况。结果:静脉置管后CRT发生率为98.33%;PC、MPV、PDW与CRT严重程度均无相关性(P>0.05);PC在生理盐水组与甘露醇组中,均呈现置管后先升高后降低的趋势;留置1 d时,空白对照组MPV、PDW均高于生理盐水组与甘露醇组,假手术组MPV、PDW均高于甘露醇组(P<0.05)。结论:血小板活性增强可能不是CRT发生的主要原因,不能依靠PC、MPV、PDW的变化来预测CRT的发生、发展。
Objective To investigate the relationship between the variation of platelet parameters and the occurrence and development of catheter-related thrombosis （CRT） in a rabbit model of catheter infusion in different times. Methods New Zealand big ear rabbits were randomized into control , sham and catheterization groups. The last group was further subdivided into saline and mannitol groups on condition of indwelling time points of days 1,3 and 5. Blood samples were collected for testing platelet parameters, including PC, MPV and PDW, before indwelling and days 1, 3 and 5 after catheteration. Thrombosis was observed in specimens of indwelled or ipsilateral external jugular veins. Results Venous catheter indwelling caused CRT by 98.33%. There were no correlations between thrombosis severity and PC, MPV,PDW （P 〉 0.05）. In the saline and mannitol groups, the concentrations of PC began to rise at first and then decline after catheteration. On the 1st day, the concentrations of MPV and PDW in the control group were higher than those of the saline and mannitol groups, and the concentrations of MPV and PDW in shame group were higher than that of the mannitol groups （P 〈 0.05）. Conclusion The occurrence of the CRT may not be caused by the activation of platelets. It is not helpful by testing platelet parameters to predict the occurrence and development of CRT.
出处
《实用医学杂志》
CAS
北大核心
2016年第21期3502-3506,共5页
The Journal of Practical Medicine
基金
国家自然科学基金项目(编号:81260290)
广西卫生厅广西医疗卫生重点科研课题(编号:重2012113)
广西自然科学基金项目(编号:2013GXNSFAA019188)
