Moldal Elena R, Kristensen Annemarie T, Peeters Marijke E, Nødtvedt Ane, Kirpensteijn Jolle
Department of Companion Animal Clinical Sciences, Norwegian School of Veterinary Science, 0033 Oslo, Norway.
Am J Vet Res. 2012 Sep;73(9):1469-76. doi: 10.2460/ajvr.73.9.1469.
To investigate the hemostatic response to surgery and compare the response for ovariohysterectomy with that for ovariectomy and to evaluate the usefulness of thromboelastography on plasma samples.
42 female dogs.
Dogs were assigned to undergo ovariohysterectomy or ovariectomy. Blood samples were collected immediately before and 1, 6, and 24 hours after surgery and stored at -80°C for subsequent analysis. Plasma samples were subjected to thromboelastography after thawing. In addition, coagulation variables were measured, including concentrations of von Willebrand factor antigen, fibrinogen, antithrombin, and protein C; activity of factor VIII; activated partial thromboplastin time; prothrombin time; and thrombin time. The fibrinolytic response was assessed via concentrations of D-dimer, plasminogen, and α-2-antiplasmin (plasmin inhibitor).
Substantial hemostatic and fibrinolytic activation was evident after surgery in both groups, as characterized by significantly increased global clot strength and an overall hypercoagulable state at 4 hours after surgery in addition to decreases in von Willebrand factor antigen and factor VIII concentrations and shortened prothrombin and thrombin times. The dogs also typically had activation of the fibrinolytic system, as evidenced by increased postoperative concentrations of D-dimer, plasminogen, and plasmin inhibitor. Differences between the 2 groups could not be detected for any variables.
Elective surgery with limited tissue trauma induced hemostatic activation in dogs, which led to hypercoagulability after surgery. A difference between the ovariohysterectomy and ovariectomy groups was not detected. Thromboelastography can be used on plasma samples and may be useful for evaluating patterns over time.
研究手术的止血反应,并比较卵巢子宫切除术与卵巢切除术的止血反应,评估血栓弹力图在血浆样本上的实用性。
42只雌性犬。
将犬分为接受卵巢子宫切除术或卵巢切除术两组。在手术前以及手术后1、6和24小时立即采集血样,并储存在-80°C以备后续分析。血浆样本解冻后进行血栓弹力图检测。此外,测定凝血变量,包括血管性血友病因子抗原、纤维蛋白原、抗凝血酶和蛋白C的浓度;因子VIII活性;活化部分凝血活酶时间;凝血酶原时间;以及凝血酶时间。通过D-二聚体、纤溶酶原和α-2-抗纤溶酶(纤溶酶抑制剂)的浓度评估纤溶反应。
两组手术后均出现明显的止血和纤溶激活,其特征为术后4小时整体凝血强度显著增加以及总体高凝状态,同时血管性血友病因子抗原和因子VIII浓度降低,凝血酶原和凝血酶时间缩短。犬还通常出现纤溶系统激活,术后D-二聚体、纤溶酶原和纤溶酶抑制剂浓度升高证明了这一点。两组之间在任何变量上均未检测到差异。
组织创伤有限的择期手术在犬中诱导了止血激活,导致术后高凝状态。未检测到卵巢子宫切除术组和卵巢切除术组之间的差异。血栓弹力图可用于血浆样本,可能有助于评估随时间的变化模式。