接受食道癌手术的患者没有损害血静
Tua Gyldenholm1,2, Nina Madsen3, Niels Katballe2,4
1Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.
概括
消化管切除术患者很少经历严重出血或需要输血. 血液静止在整个外科手术期间保持完整,这表明在此次重大癌症手术期间没有损伤.
科学领域:
- 在瘤学瘤学.
- 手术病理学手术病理学
- 血液学 血液学 血液学
背景情况:
- 输卵管切除术是一项重要的瘤手术,具有可变的出血风险.
- 经管切除术后经手术期间出血中血静受损的作用尚未完全理解.
- 调查凝血动态对于管理手术出血至关重要.
研究的目的:
- 综合评估为癌症而接受食道切除术的患者的术前凝血.
- 为了确定血静受损是否有助于在食道切除术期间和之后的出血.
- 为了评估动态的全球血静,使用血小板结合测试和血小板聚合测试.
主要方法:
- 对87名患有食道腺癌或状细胞癌的成年患者进行前性研究.
- 测量手术出血量和输血.
- 血液样本的分析使用旋转血栓等度 (ROTEM®),多板分析仪 (Multiplate Analyzer®) 进行血小板聚合,并在三个时间点进行常规凝血测试.
主要成果:
- 平均流血量为300毫升;严重出血 (>1000毫升) 是不常见的.
- 只有16%的患者接受了输血.
- 血小板聚合和ROTEM®分析表明血液静止完好,没有明显的经手术后血块形成或强度下降.
结论:
- 严重的术后出血和需要输血的血液产品在食道切除术中很少见.
- 由于癌症而接受食道切除术的患者保持完整的血液静止.
- 血液静止障碍似乎不是这一组患者外科手术期间出血的重要因素.
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