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[与脑病变相关的高凝综合征。原发性脑肿瘤手术期间凝血功能的前瞻性研究(17例)]

[Hypercoagulability syndrome associated with cerebral lesions. Prospective study of coagulation during surgery of primary brain tumors (17 cases)].

作者信息

Hsieh V, Molnar I, Ramadan A, Safran A B, Bouvier C A, Berney J

出版信息

Neurochirurgie. 1986;32(5):404-9.

PMID:3808167
Abstract

Variations in hemostatic factors have been studied in 17 patients undergoing neurosurgical operations for intracerebral primary tumors. Clotting time (plastic and glass), recalcification time (Howell), plasma fibrinogen level, fibrin split products, partial thromboplastin time, Quick and platelet count were measured before and after the surgical procedure and several times during the following 24 hours. Hemostasis was significantly disturbed, with maximal hypercoagulability 2 hours after operation. In 3 patients, fundus examination showed occlusion of retinal vessels. In all cases the surgical trauma was relatively minor compared with severe cerebral contusion, but was nevertheless enough to disturb the measured parameters, which appear to be sensitive indicators for assessing the severity of cerebral lesions, especially in cases of contusion. A systematic fundus examination is also of diagnostic interest. The state of blood hypercoagulability may lead to disseminated intravascular clotting (DIC) and therefore prophylactic heparin therapy should be administered.

摘要

对17例接受脑原发性肿瘤神经外科手术的患者的止血因子变化进行了研究。在手术前后以及术后24小时内多次测量凝血时间(塑料和玻璃管法)、再钙化时间(豪厄尔法)、血浆纤维蛋白原水平、纤维蛋白降解产物、部分凝血活酶时间、奎克试验和血小板计数。止血功能受到明显干扰,术后2小时出现最大程度的高凝状态。3例患者眼底检查显示视网膜血管闭塞。与严重脑挫伤相比,所有病例的手术创伤相对较小,但仍足以干扰所测量的参数,这些参数似乎是评估脑损伤严重程度的敏感指标,尤其是在挫伤病例中。系统的眼底检查也具有诊断意义。血液高凝状态可能导致弥散性血管内凝血(DIC),因此应给予预防性肝素治疗。

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