Charnaia M A, Morozov Iu A, Gladysheva V G, Roĭtman E V, Isaeva A M, Belov Iu V, Goncharova A V
Angiol Sosud Khir. 2005;11(4):27-31.
This paper describes hemostatic changes in patients who had undergone aortic surgery under conditions of extracorporeal circulation. The changes in the hemostatic system are marked by the thrombophilic condition made up for activation ox blood fibrinolytic activity in the preoperative period. The basic amount of blood loss falls within the first 6 hours after operation. Prolonged hypothermic extracorporeal circulation and the high intraoperative blood loss (over 35 ml/kg bw) lead to an appreciable decrease in antithrombin III and protein C activity which results in activation of disseminated intravascular blood coagulation in the early postoperative period and ineffectiveness of heparin therapy. Secondary hyperfibrinolysis together with combined thrombocytopenia and platelet dysfunction are the basic causes of higher than usual bleeding in patients after aortic surgery under conditions of extracorporeal circulation.
本文描述了在体外循环条件下接受主动脉手术患者的止血变化。止血系统的变化表现为术前形成的血栓形成倾向状态，伴有纤溶活性激活。术后最初6小时内失血基本量最大。长时间低温体外循环和术中大量失血（超过35毫升/千克体重）导致抗凝血酶III和蛋白C活性显著降低，这导致术后早期弥散性血管内凝血激活以及肝素治疗无效。继发性高纤溶状态以及合并的血小板减少和血小板功能障碍是体外循环条件下主动脉手术后患者出血比平常更多的基本原因。
