中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (02): 106-107.

• 论著 • 上一篇    下一篇

肝胆胰外科病人围手术期大量输血合并凝血障碍11例分析

金浩生，区金锐   

  1. 广东省人民医院肝胆胰外科 广东省医学科学院，广东广州510080
  • 出版日期:2010-02-01 发布日期:2010-03-11

  • Online:2010-02-01 Published:2010-03-11

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摘要：

目的    探讨肝胆胰外科病人围手术期大量输血合并凝血障碍的原因及正确处理方法。 方法    回顾分析2006年1月至2009年7月广东省人民医院肝胆胰外科诊治11例肝胆胰外科病人围手术期大量输血合并凝血障碍的临床资料。 结果    通过个体化、全面有步骤地输注各类凝血物质，并选择恰当的外科治疗等其他相关措施, 其中10例病人凝血障碍得到纠正，术后恢复顺利；1例脾脏切除、门奇断流、胆囊切除术病人术后发生门静脉广泛栓塞死亡。 结论    肝胆胰外科病人发生围手术期大量输血合并凝血障碍，应冷静分析病情，正确判断凝血障碍主要原因，合理利用各类凝血物质，选择恰当的外科治疗及其他相关措施。

关键词: 围手术期, 大量输血, 凝血障碍, 肝胆胰疾病

Abstract:

Perioperative management of massive blood transfusion with dysfunction of blood coagulation in hepatopancreatobiliary surgery        JIN Hao-sheng，OU Jin-rui. Department of Hepatopancreatobiliary Surgery, Guangdong General Hospital , Guangdong Academy of Medical Sciences, Guangzhou 510080 , China
Corresponding  author：OU Jin-rui ，E-mail: oujinrui@yahoo.com.cn
Abstract    Objective    To summarize the experience in perioperative management of massive blood transfusion with dysfunction of blood coagulation in hepatopancreatobiliary surgery.  Methods    The clinical data of 11 cases underwent massive blood transfusion with dysfunction of blood coagulation in hepatopancreatobiliary surgery from January 2006 to July 2009 at the Department of Hepatopancrea to biliary Surgery of Guangdong General Hospital were analyzed retrospectively. Results    Through individualized, comprehensive and gradually infusion of various types of blood clotting substances, the appropriate surgical treatment and other relevant measures, 10 cases of dysfunction of blood coagulation were corrected; one case of splenectomy, porto-azygos devascularization and cholecystectomy died of wide range of portal vein thrombosis.  Conclusion    It should correctly judge the main reason of massive blood transfusion with dysfunction of blood coagulation in hepatopancreatobiliary surgery, rationally use of various types of blood clotting substances and choose the appropriate surgical treatment and other relevant measures.

Key words: perioperative period, massive blood transfusion, coagulopathy, hepatobiliary and pancreatic diseases