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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。
Objective To investigate the causes and the correct treatment of massive blood transfusion and coagulopathy in patients with hepatobiliary and pancreatic surgery during perioperative period. Methods The clinical data of 11 patients with hepatobiliary and pancreatic surgery who were admitted to Guangdong Provincial People’s Hospital from January 2006 to July 2009 were analyzed retrospectively. Results Through individualized and comprehensive infusion of various types of coagulation substances in a step-by-step manner, other appropriate measures such as appropriate surgical treatment were selected. Among them, coagulation disorders were corrected in 10 patients and postoperative recovery was successful. One case of splenectomy, , Cholecystectomy occurred in patients with extensive portal vein embolization. Conclusion A large number of patients with hepatobiliary and pancreatic surgery perioperative blood coagulation disorders occur, should be calm analysis of the disease, the correct judgments of the main causes of coagulation disorders, rational use of various coagulation substances, the appropriate choice of surgical treatment and other related measures.