Joyeux H, Joyeux A, Raoux P, Yakoun M, Blanc F, Rouanet C, Said H O, Pujol H, Solassol C
J Chir (Paris). 1978 Aug-Sep;115(8-9):465-72.
The authors relate 15 cases of blood coagulation disturbances among three groups of animals after 80%, 90% or total hepatectomy. Animals in group I, after 80% hepatectomy, were sacrified between the 10th and 30th postoperative days. Group II animals, with 90% hepatectomy, survived for periods ranging from 18 to 24 hours. In group III, after total hepatectomy, survival varied between 30 and 40 hours. The coagulation disturbances which were observed following 80% hepatectomy were spontaneously compatible with the survival of the animals. Following 90% and total hepatectomy the resulting disturbances were constantly severe enough to limit survival time. Supportive procoagulant therapy associated with sequential heparin administration seems justified by the insufficient biosynthesis of clotting factors and their unavoidable consumption as a result of localized then disseminated intravascular coagulation and secondary fibrinolysis.
作者报告了80%、90%肝切除或全肝切除后三组动物中15例凝血功能障碍的情况。第一组动物行80%肝切除后,于术后第10天至第30天处死。第二组动物行90%肝切除,存活时间为18至24小时。第三组动物行全肝切除后,存活时间在30至40小时之间。80%肝切除后观察到的凝血功能障碍与动物存活自发相容。90%肝切除和全肝切除后产生的障碍持续严重到足以限制存活时间。由于凝血因子生物合成不足以及局部然后弥漫性血管内凝血和继发性纤维蛋白溶解导致的不可避免的消耗,与序贯肝素给药相关的支持性促凝治疗似乎是合理的。