mbt chaussure Fibrinogen in patients after liver t

lin06900 · Wysłany: Pią 18:39, 25 Mar 2011

Fibrinogen in patients after liver transplantation coagulation

Disease, occurred in the postoperative 3d, bleeding from the disease when liver resection strip wound, the true edge of the diaphragm graft vascular anastomosis Louxue or anastomotic rupture is extremely rare, usually caused by inadequate intraoperative bleeding and surgery After coagulation dysfunction caused by the occurrence rate of 5.8%, due to massive blood loss after liver implantation of the new blood and oxygen supply, can affect the new liver functional recovery J. Also, endotoxin in the blood of patients with many inflammatory neurotransmitters are increased, a large number of blood transfusion also increases the chance of exogenous infection, making the perioperative period to increase the chances of infection. Reliable vascular anastomosis, preoperative, intraoperative and postoperative correction of coagulation dysfunction, reduce blood loss, blood transfusion and the abdomen was closed properly before the bleeding is to reduce the critical early postoperative intra-abdominal hemorrhage. This study showed that patients in the postoperative period, according to the abdominal cavity bleeding and coagulation monitoring in addition added prothrombin complex,[link widoczny dla zalogowanych], while outside the application of fresh plasma fibrinogen improved coagulation, PT,[link widoczny dla zalogowanych], AFIT shortened significantly. Anticoagulant therapy after liver transplantation using the main purpose is to prevent vascular anastomosis thrombosis, particularly hepatic artery thrombosis. Postoperative 1d, new liver synthesis of coagulation factor function that is restored, but inhibited the synthesis of functional clotting substances slow recovery, this recovery is not synchronized and the liver caused by endotoxemia, systemic inflammation, immune inhibitors, also easily lead to postoperative hypercoagulable state, with data reported after liver transplantation the incidence of hepatic artery thrombosis was 5.6% to 20% and mortality by 15% to 18%, after 2 weeks for high-risk period I. As the new liver will take several days to implant the gradual recovery of liver function, and thus less postoperative blood coagulation,[link widoczny dla zalogowanych], this time should pay attention to the prevention of bleeding disorders, anticoagulant drug application to be careful. For the coagulation dysfunction in procoagulant should also pay attention to the treatment of hyperparathyroidism secondary fibrinolysis and thrombosis,[link widoczny dla zalogowanych], such as input excessive clotting factors, may lead to the formation of m bolt, resulting in serious consequences. According to the group observed early after liver transplantation, there were more abnormal coagulation, timely monitoring and control of its very important at the appropriate application of fibrinogen on PT, APTr a certain sense,[link widoczny dla zalogowanych], the recovery of targets. As the liver function recovered gradually improved coagulation function, and you should weigh the risk of bleeding and thrombosis may be combined with bedside color vascular ultrasound, proper use of drugs that affect coagulation. Strengthen regulation and control, to avoid excessive anticoagulation to reduce bleeding and postoperative mortality is of great significance.
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