血栓弹力图在评价脑出血患者围手术期凝血功能中的应用价值

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1、授予单位代码10089学号或申请号15067中国图书分类号R651.1HebeiMedicalUniversity硕士学位论文学术学位血栓弹力图在评价脑出血患者围手术期凝血功能中的应用价值研究生:王丽丽导师：吴建梁教授专业：外科学二级学院：第二医院2018年3月目录中文摘要··········································································································1英文摘要·············································

2、·····························································3研究论文血栓弹力图在评价脑出血患者围手术期凝血功能中的应用价值前言··········································································································5材料与方法······················································································

3、··5结果··········································································································7附表··········································································································9讨论······································································

4、····································11结论··········································································································17参考文献·····························································································17综述血栓弹力图用于脑出血围手术期中的临床研究························

5、······21致谢··········································································································29个人简历··········································································································30血栓弹力图在评价脑出血患者围手术期凝血功能中的应用价值摘要目的：分析脑出血患者术前及术后的凝血状态，探讨血栓弹力图在评价脑出血

6、患者围手术期凝血功能中的应用价值。方法：收集2016年1月至2017年10月就诊于中国人民解放军第二五一医院诊断为脑出血且接受急诊手术治疗的患者40例作为开颅手术组；选择同期就诊于我院未进行手术的少量脑出血患者40例作为保守治疗组。观察两组患者血栓弹力图各指标的变化。纳入标准：①发病6小时内入院，头颅CT检查明确诊断为脑出血患者，且开颅手术组患者入院后2小时内行手术治疗；②性别不限，年龄20-70岁，符合条件患者签署知情同意书。排除标准：①脑出血前有服用抗凝药物史，或出血前正在接受抗凝治疗的患者；②中途放弃治疗，或因其他原因中途退出实验者；③女性患者月经期者；④患者血液系统疾病或

7、相关遗传病，凝血功能异于常人的；⑤患者患有原发系统性疾病，严重影响患者预后者；⑥蛛网膜下腔出血，伴有动脉瘤、血管畸形或烟雾病等；⑦肿瘤卒中；⑧大面积脑梗塞后出血；⑨脑外伤所致的脑出血；⑩术中输血。观察指标①凝血反应时间（R）：正常值为3-8min。②血凝块形成时间（K）：正常值为1-3min。③凝固角（α角）：正常值为55°-78°。④最大血凝块强度（MA）：正常值为51-75mm。⑤凝血综合指数（CI）：正常值为-3-+3。统计学方法：所有检验所得的数据均采用SPSS22.0统