Israelian L A, Lubnin A Iu, Tseĭtlin A M, Stepanenko A Iu, Kazarian A A, Golovteev A L, Melikian A G
Anesteziol Reanimatol. 2010 Jul-Aug(4):50-4.
The paper gives the results of analyzing the hemostatic system in 26 patients with various neurosurgical diseases on the basis of routine laboratory biochemical tests and thromboelastographic indicators. In all the patients, the pattern of the disease contained an epilepsy syndrome that required mono- or combination therapy with valproic acid. Laboratory indicators of clinical hypocoagulation were found to develop during the use of valproic acid, and its monotherapy in particular. Hemorrhagic complications were also analyzed in not only the immediate, but also late postoperative period (for as long as 6 months after surgery). Two cases of severe late complications, such as formation of chronic subdural hematomas requiring surgical intervention, were diagnosed in the valproate monotherapy group. A tactic using a thromboelastographic technique is proposed to prepare these patients for further neurosurgical intervention.
本文基于常规实验室生化检测和血栓弹力图指标，给出了对26例患有各种神经外科疾病患者的止血系统分析结果。所有患者的疾病模式均包含癫痫综合征，需要使用丙戊酸进行单药治疗或联合治疗。发现在使用丙戊酸期间，尤其是单药治疗时，会出现临床低凝的实验室指标。不仅在术后即刻，而且在术后晚期（长达术后6个月）也对出血并发症进行了分析。在丙戊酸单药治疗组中诊断出2例严重的晚期并发症，如形成需要手术干预的慢性硬膜下血肿。提出了一种使用血栓弹力图技术的策略，为这些患者进一步的神经外科干预做准备。
