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夹闭解除性休克期间的止血功能紊乱

Disturbances of hemostasis during declamping shock.

作者信息

Głowiński S, Gacko M, Głowiński J, Worowska A, Maksymczuk M, Worowski K

机构信息

Department of Vascular Surgery and Transplantology, Medical Academy of Bialystok.

出版信息

Rocz Akad Med Bialymst. 1995;40(1):156-64.

PMID:8528986
Abstract

The aorta, above or below renal arteries was clamped for 60 minutes, in a canine model. The blood was taken for testing from above the aorta bifurcation before clamping, after 30 minutes of its duration, directly after declamping and every 30 minute during next 4 hours. Irrespective of clamping level, the platelet count, clot retraction and prothrombin consumption do not undergo significant changes. However, the activity of platelet factor 4 is increased. Prothrombin time, recalcination time, kaolin-kephalin time and the activities of factors V, VII, XI and XII do not differ as well. Thrombin time is prolonged and antithrombin III activity is reduced. Euglobulin fibrinolysis time undergoes prolongation and antiplasmin content is increased. The observed changes show a variable tendency, regardless of clamping level and increase with the passage of experiment time. An increase in the coagulation activity and a decrease in the fibrinolytic activity of the blood plasma may be a resultant of the changes. Finally it may promote thrombus formation and indicates the preventive use of heparin.

摘要

在犬类模型中,夹闭肾动脉上方或下方的主动脉60分钟。在夹闭前、夹闭30分钟后、松开夹闭后立即以及接下来4小时内每30分钟从主动脉分叉上方取血进行检测。无论夹闭水平如何,血小板计数、血块回缩和凝血酶原消耗均无显著变化。然而,血小板因子4的活性增加。凝血酶原时间、复钙时间、高岭土 - 脑磷脂时间以及因子V、VII、XI和XII的活性也无差异。凝血酶时间延长,抗凝血酶III活性降低。优球蛋白溶解时间延长,抗纤溶酶含量增加。观察到的变化呈现出可变趋势,与夹闭水平无关,并随实验时间的推移而增加。血浆凝血活性增加和纤溶活性降低可能是这些变化的结果。最后,这可能促进血栓形成,并表明需要预防性使用肝素。

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