摘要
目的 为探讨手术后缺血性心、脑血管病的发病机理。方法 应用 8条犬于颞骨切除术后不用任何治疗 ,连续观察 5d内血液流变学的变化。结果 犬术后 2h全血粘度明显升高 (P <0 0 5) ,2 4h后恢复并稳定在正常状态 ;血浆粘度一直无明显改变 ;血沉于术后 2 4h明显加快 (P <0 0 5) ,持续至 5d ;纤维蛋白原亦于 2h后开始增加 ,至第 5d时具有统计学意义 (P <0 0 5) ;而红细胞压积于术后 2h明显升高 (P <0 0 5) ,2 4h显著下降(P <0 0 5) ,也持续至 5d ,并与全血粘度的改变呈正相关 (r=0 7778,P <0 0 5)。结论 在正常生理情况下 ,手术可引起血液流变学的显著异常 ,但由于机体的自我调节作用 ,2 4h以内红细胞压积下降 ,血粘度恢复正常 ,并稳定至 5d以后 ,而对血沉加快和纤维蛋白原升高的调节作用不明显。因此 ,为了预防手术后早期发生缺血性心、脑血管疾病 ,应在手术后 2 4h以内采用血液稀释疗法 ,而 2
Objective To understand the effects of operation (or trauma) on hemorrheology and in order to clarify the pathogenesis of ischemic cardiovascular and cerebrovascular diseases.The changes of blood viscosity,plasma viscosity,hematocrit (HCT),erythrocyte sedimentation rate(ESR) and fibrinogen(FG) were detected at 2,24,72 and 120 hours,respectively,after operation in subtemporal craniotomied dogs(n=8) without any treatment.Results:⑴The blood viscosity was increased significantly at 2 hours after operation ,it was recovered to normal after 24 hours.On the other hand,the plasma viscosity didn't change at all.⑵Both the HCT and ESR were risen significantly at the postoperation,continued over 120 hours.⑶FG was obviously elevated until the 120 hours.⑷The change of blood viscosity was positively correlated with HCT.Conclusions:The operation (or trauma) might cause the change of hemorrheology,but by self-regulation of the dogs,the HCT reduced within 24 hours,and the blood viscosity recovered to normal level,and persisted over 5 days.The self-regulating ability on ESR and FG levels was very limit within 120 hours.Prevention of postoperative (or post-traumatic) ischemic diseases of heart and brain,blood dilution therapy should be performed as soon as possible in the postoperation or post-trauma within 24 hours.After 24 hours,the therapy to reduce the levels of FG and ESR should be adopted as main method.
出处
《中国医师杂志》
CAS
2001年第1期18-19,共2页
Journal of Chinese Physician
