Lara-García A, Couto C G, Iazbik M C, Brooks M B
Department of Veterinary Clinical Sciences and Veterinary Teaching Hospital, The Ohio State University, Columbus, Ohio, USA.
J Vet Intern Med. 2008 May-Jun;22(3):525-33. doi: 10.1111/j.1939-1676.2008.0088.x. Epub 2008 May 2.
Some retired racing Greyhounds (RRG) that undergo surgery bleed excessively.
Greyhounds that bleed excessively will have one or more preoperative hemostatic abnormalities that can be used to predict the risk and severity of postoperative bleeding.
Eighty-eight RRG undergoing ovariohysterectomy or castration.
All dogs were evaluated preoperatively with a physical exam, CBC, platelet count, OSPT, APTT, platelet function with PFA-100(a); fibrinogen, d-dimer, plasminogen (Plmg), antiplasmin (AP), antithrombin (AT), and vWF concentration (vWF:Ag); vWF collagen binding assay (vWF:CBA), and Factor XIII assay. Assays were repeated in the dogs that bled, and in an age- and sex-matched control group of RRG.
Twenty-six percent of the dogs had bleeding 36-48 hours after surgery. AP (P <.0001) and AT concentration (P= .007) were significantly lower, and vWF:CBA (P= .0284) was higher preoperatively in the dogs with excessive hemorrhage. A lower platelet count (P= .001) and hematocrit (P= .002), shorter OSPT (P= .0002) and higher plasma fibrinogen (P <.0001), and AP (P= .001) concentration were detected at the time of bleeding compared with preoperative values in the dogs that bleed excessively. The same findings were observed postoperatively for the control group, except for the decrease in hematocrit.
The results indicate that this excessive postoperative bleeding is not attributable to a primary or secondary hemostatic defect, but could result from altered fibrinolysis.
一些接受手术的退役赛犬出血过多。
出血过多的赛犬会有一个或多个术前止血异常情况,可用于预测术后出血的风险和严重程度。
88只接受卵巢子宫切除术或去势手术的退役赛犬。
所有犬只术前均进行体格检查、全血细胞计数、血小板计数、一期止血时间(OSPT)、活化部分凝血活酶时间(APTT)、血小板功能分析仪检测(PFA-100(a));纤维蛋白原、D-二聚体、纤溶酶原(Plmg)、抗纤溶酶(AP)、抗凝血酶(AT)和血管性血友病因子浓度(vWF:Ag);血管性血友病因子胶原结合试验(vWF:CBA)和因子 XIII 检测。对出血的犬只以及年龄和性别匹配的退役赛犬对照组重复进行检测。
26%的犬只在术后36 - 48小时出血。出血过多的犬只术前抗纤溶酶(P <.0001)和抗凝血酶浓度(P =.007)显著降低,血管性血友病因子胶原结合试验(P =.0284)较高。与术前相比,出血过多的犬只出血时血小板计数(P =.001)和血细胞比容(P =.002)降低,一期止血时间缩短(P =.0002),血浆纤维蛋白原升高(P <.0001),抗纤溶酶(P =.001)浓度升高。对照组术后观察到相同结果,但血细胞比容降低除外。
结果表明,这种术后过度出血并非源于原发性或继发性止血缺陷,而是可能由纤溶改变导致。