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鼻旁窦内镜手术患者围手术期凝血系统选定参数的评估

Evaluation of selected parameters of the coagulation system during the perioperative period in patients undergoing endoscopic surgery of the paranasal sinuses.

作者信息

Urbaniak Joanna, Owczarek Kalina, Miłoński Jarosław, Pietkiewicz Piotr, Jałocha-Kaczka Anna, Olszewski Jurek

机构信息

Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Medical University of Lodz, Lodz, Poland.

出版信息

Arch Med Sci. 2018 Jan 4;16(6):1336-1345. doi: 10.5114/aoms.2017.72544. eCollection 2020.

Abstract

INTRODUCTION

The aim of the study was to evaluate selected parameters of the coagulation system during the perioperative period in patients undergoing endoscopic sinus surgery.

MATERIAL AND METHODS

The study involved 121 patients: group I - 42 patients who did not receive anticoagulatory or antiplatelet medications, qualified for endoscopic sinus surgery under total intravenous anaesthesia (TIVA); group II - 40 patients who received in the perioperative period low-molecular-weight heparins, qualified for endoscopic sinus surgery under TIVA; group III - 39 patients diagnosed according to a schedule, due to vertigo or loss of hearing. All the patients received a full laryngological examination and detailed audiological and otoneurological diagnostics, and examination of selected haemostatic parameters before the surgery/diagnostics.

RESULTS

The analysis of concentrations of coagulation parameters in groups I and II revealed a statistically significantly higher international normalized ratio value before surgery (I - 1.11; II - 1.08) and 48 h following surgery (I - 1.15; II - 1.10) in group I. The concentration of coagulation factor VII in the study patients was considerably higher in group I for all three measurements (481.93; 443.13; 486.02). The concentration of fibrinogen (coagulation factor I) was significantly lower in group I before surgery (3.2) and at 6 h after surgery (2.84). A significantly lower level of von Willebrand factor was found in group I before surgery (2.94). Comparing test results of groups I and III, who did not receive antiaggregants, statistically significant differences were observed in both tests for factors VII and VIII.

CONCLUSIONS

Concentrations of von Willebrand factor and prothrombin revealed statistically significant differences in between groups.

摘要

引言

本研究的目的是评估接受内镜鼻窦手术患者围手术期凝血系统的选定参数。

材料与方法

本研究纳入121例患者:第一组 - 42例未接受抗凝或抗血小板药物治疗的患者,符合在全静脉麻醉(TIVA)下进行内镜鼻窦手术的条件;第二组 - 40例在围手术期接受低分子量肝素治疗的患者,符合在TIVA下进行内镜鼻窦手术的条件;第三组 - 39例因眩晕或听力丧失按计划诊断的患者。所有患者均接受全面的喉科检查、详细的听力学和耳神经学诊断,并在手术/诊断前检查选定的止血参数。

结果

对第一组和第二组凝血参数浓度的分析显示,第一组在手术前(第一组 - 1.11;第二组 - 1.08)和手术后48小时(第一组 - 1.15;第二组 - 1.10)的国际标准化比值在统计学上显著更高。在所有三次测量中,第一组研究患者的凝血因子VII浓度相当高(481.93;443.13;486.02)。第一组手术前(3.2)和手术后6小时(2.84)的纤维蛋白原(凝血因子I)浓度显著较低。第一组手术前的血管性血友病因子水平显著较低(2.94)。比较未接受抗聚集剂的第一组和第三组的测试结果,在凝血因子VII和VIII的两项测试中均观察到统计学上的显著差异。

结论

血管性血友病因子和凝血酶原的浓度在组间显示出统计学上的显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3e1/7667416/5525d0fe2f06/AMS-16-6-31427-g001.jpg

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