经过导管大动脉植入术后凝血和血小板对凝血强度的贡献的术后变化:使用血栓显微镜和常规标记物的研究
Takeyuki Sajima1, Mae Harada1, Taichi Onimaru1
1Department of Anesthesiology, Teikyo University Hospital, Itabashi-ku, Japan.
Perfusion
|November 14, 2023
概括
通过导管的大动脉植入 (TAVI) 与改变凝血和减少血小板功能相关. 这项研究发现TAVI后凝血增加和血小板对凝血强度的贡献减少,影响了抗血栓治疗决策.
科学领域:
- 心血管医学 心血管医学
- 血液学 血液学 血液学
- 手术创新 在外科创新.
背景情况:
- 过导管大动脉植入 (TAVI) 是严重的大动脉狭窄的常见程序.
- 血栓和出血并发症是TAVI后已知的风险.
- 在TAVI后凝血和血小板功能的术后变化需要进一步调查以指导抗血栓策略.
研究的目的:
- 为了研究TAVI后凝血和血小板功能的术后变化.
- 评估血小板功能对血栓强度的贡献,使用血栓形成显微镜 (TEG 6s).
主要方法:
- 对15名接受TAVI的患者进行前性观察性研究.
- 在手术前和手术后的第1天和第3天进行的血栓形成显微镜 (TEG 6s) 测量.
- 对凝血参数 (R,K,α,MA,CI) 和血小板对凝血强度 (Gp) 的贡献进行分析.
主要成果:
- 与基线相比,手术后的第一和第三天凝血参数表明凝血活性增加.
- 血小板对凝块强度 (Gp) 的贡献在术后第1天和第3天显著下降.
- 最大幅度 (MA) 和凝血指数 (CI) 没有显著变化.
结论:
- 凝血功能倾向于在TAVI后增加,而血小板对凝血强度的贡献则下降.
- 研究结果表明,TAVI后静血平衡发生了转变.
- 需要进行进一步的研究,以建立TAVI后最佳的抗血栓指南.
相关概念视频
Formation of the Platelet Plug
6.5K
The platelet phase, the second stage of hemostasis, commences around 15-20 seconds after an injury. It follows and overlaps with the vascular phase, during which blood vessels constrict to minimize blood loss.
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
6.5K
Aneurysm IV: Nursing Management
8
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
8
Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
Peripheral Artery Disease V: Postoperative Nursing Management
11
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
11
Coagulation
6.9K
The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
6.9K
Introduction to Hemostasis
8.1K
Hemostasis is a complex physiological process that prevents excessive bleeding when a blood vessel is injured. It's crucial for maintaining the integrity of the circulatory system, as it ensures that our blood remains fluid while still within the vascular network and yet clots to prevent blood loss upon vessel injury.
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
8.1K


