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目的观察重症肝病患者凝血指标特点并探讨其预防继发性出血的临床意义。方法选择本院2009年1月-2011年5月收治的重症肝病患者80例作为观察组,其中重型肝炎患者32例,肝硬化患者30例,肝癌患者18例(未进行放、化疗),检测患者的凝血指标,包括凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及纤维蛋白原(FIB),并以同期随机选择的健康体检者30例作为对照组,总结重症肝病患者凝血指标变化特点。结果重型肝炎、肝硬化、肝癌患者的PT、APTT均明显延长,FIB明显减低,与对照组比较,差异均有统计学意义(P<0.05)。结论重症肝病患者凝血指标异常,患者血液处于明显低凝状态、具有出血倾向,其监测有助于及早发现重症肝病患者的凝血机制障碍,对预防继发性出血及改善预后有重要的临床意义。
Objective To observe the characteristics of coagulation index in patients with severe liver disease and explore its clinical significance in preventing secondary hemorrhage. Methods Eighty patients with severe liver disease admitted to our hospital from January 2009 to May 2011 were selected as the observation group, including 32 cases of severe hepatitis, 30 cases of liver cirrhosis, 18 cases of hepatocellular carcinoma (without radiotherapy and chemotherapy) and the detection The coagulation indexes of patients, including prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB), were compared with 30 healthy subjects randomly selected in the same period as the control group, and the patients with severe liver disease Changes in coagulation index characteristics. Results The PT and APTT were significantly prolonged in patients with severe hepatitis, cirrhosis and hepatocellular carcinoma, and the FIB was significantly lower than that in the control group (P <0.05). Conclusion The coagulation index of patients with severe liver disease is abnormal. The blood of the patient is in a state of obvious hypocoagulation with a tendency of bleeding. Monitoring can help detect the clotting mechanism obstacle in patients with severe liver disease early and has important clinical significance in preventing secondary hemorrhage and improving prognosis.