维吾尔族、汉族小儿先天性心脏病围手术期凝血功能与肝素耐药相关研究

发布时间：2018-03-12 22:52

本文选题：维吾尔族　切入点：小儿　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:新疆维吾尔族和汉族先天性心脏病小儿体外循环下凝血功能和肝素耐药的相关研究。方法:随机选取我院确诊为先天性心脏病的维吾尔族、汉族先天性心脏病患儿320例分为维族组和汉族组。于术前、出室、术后24h三个时间点分别采血观察维汉两组PT、APTT、FIB、TT、PLT的变化,以及手术时间、体外循环时间、24小时胸腔引流量、浓缩红细胞、血浆用量等方面资料。并根据PLT计数和民族将320例患儿分为四组:W1组:维族PLT240×109/L;W2组:维族PLT240×109/L;H1组:汉族PLT240×109/L;H2组:汉族PLT240×109/L。观察4组术前PLT计数对ACT影响以及4组肝素抗凝效果比较。结果:1两组患儿不同时间点PT、APTT、FIB、TT、PLT差异均无统计学意义(P0.05)。术后24h胸腔引流量,浓缩红细胞用量、血浆用量维族组患儿均大于汉族组患儿(P0.05)。2术前PLT计数对ACT影响W2与H2相比,差异有统计学意义(P0.05);W2组肝素耐药发生率与H2组相比,差异有统计学意义(P0.05)维吾尔族患儿肝素相对耐药的发生率(12%)明显高于汉族患儿(5.2%)。结论:1新疆维吾尔族和汉族先天性心脏病小儿体外循环下凝血指标无差异。维吾尔族小儿术后24h胸腔引流量,浓缩红细胞用量以及血浆用量多于汉族小儿。2术前PLT计数大于240×109/L的维族小儿在体外循环围手术期更容易引起ACT缩短,维吾尔族小儿发生肝素相对耐药比例高于汉族小儿。
[Abstract]:Objective: to study the relationship between coagulation function and heparin resistance in children with congenital heart disease under cardiopulmonary bypass in Xinjiang Uygur and Han nationality. 320 children with congenital heart disease in Han nationality were divided into Uygur group and Han nationality group. Blood samples were collected before operation, out of the room and 24 hours after operation to observe the changes of PTT APTTT FIBT, operation time, cardiopulmonary bypass (CPB) time and 24 hours thoracic drainage flow in Uygur and Han groups. Concentrated red blood cells, According to PLT count and nationality, 320 children were divided into four groups: Uygur group: PLT240 脳 109% L / L H2 group: Uygur group PLT240 脳 10 9 / L Li H1 group: Han nationality PLT240 脳 10 9 / L Li H 2 group: Han nationality PLT240 脳 10 9 L / L%. The effect of PLT count before operation on ACT and heparin anticoagulation in 4 groups were observed. Results there was no significant difference in PTAPTTT and FIBT between the two groups at different time points (P 0.05). The concentration of red blood cell and the dosage of plasma in Uygur group were higher than those in Han nationality group (P 0.05). The effect of PLT count on ACT in W2 group was significantly higher than that in H2 group. The incidence of heparin resistance in W2 group was significantly higher than that in H2 group. The incidence of heparin relative drug resistance in Uygur children was significantly higher than that in Han children (P 0.05). Conclusion there is no difference in coagulation indexes between Xinjiang Uygur and Han children with congenital heart disease under cardiopulmonary bypass. 24 hours after operation, the thoracic drainage volume in children of er nationality, Uygur children whose PLT count was more than 240 脳 10 9 / L before operation were more likely to shorten ACT during the perioperative period of cardiopulmonary bypass, and the rate of heparin relative resistance in Uygur children was higher than that in Han children.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.1

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