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ID 13996
Eprint ID
13996
フルテキストURL
Thumnail 105_173.pdf 607 KB
タイトル(別表記)
A clinical study of blood coagulation and fibrinolysis in vascular surgery in elderly patients
著者
杉山 章 岡山大学医学部第二外科学教室
抄録
To evaluate the pathogenesis of bleeding tendency in vascular surgery in elderly patients, the serial changes in various parameters of coagulation and fibrinolysis were investigated perioperatively in 30 patients undergoing vascular surgery and in 18 patients undergoing general surgery (control). The platelet count, platelet aggregability and plasminogen activity were lower in the group of vascular surgery than in the control group perioperatively. Thrombin-antithrombin Ⅲ complex(TAT) and plasmin-α(2) plasmin inhibitor complex(PIC) levels were high during operation. Postoperatively, the TAT level gradually decreased but the D-dimer level was high postoperatively. Although platelet aggregability increased significantly with age in the group of general surgery, it tended to decrease in that of vascular surgery. TAT and PIC levels tended to increase but the α(2) plasmin inhibitor(α(2)PI) and fibrinogen levels tended to decrease with age. In 22 patients undergoing graft replacement with abdominal aortic aneurysm, a negative correlation was observed between preoperative α(2)PI and intraoperative blood loss. However, a positive correlation was evident between the preoperative PIC level and intraoperative blood loss. These findings suggest that in vascular surgery, activities of coagulation and fibrinolysis increase and the postoperative hypercoagulable state is transient, although secondary fibrinolysis is stationary in a high level, and that in elderly patients with vascular disorders coagulating factor and anti-fibrinolytic factor tend to decrease. Surgery may induce a bleeding tendency. Furthermore, α(2)PI and PIC might be main factors in intraoperative blood loss.
キーワード
高齢者
血管外科手術
凝固線溶動態
分子マーカー
腹部大動脈瘤
発行日
1993-02-27
出版物タイトル
岡山医学会雑誌
出版物タイトル(別表記)
Journal of Okayama Medical Association
105巻
1-2号
出版者
岡山医学会
出版者(別表記)
Okayama Medical Association
開始ページ
173
終了ページ
184
ISSN
0030-1558
NCID
AN00032489
資料タイプ
学術雑誌論文
オフィシャル URL
https://www.jstage.jst.go.jp/article/joma1947/105/1-2/105_1-2_173/_article/-char/ja/
関連URL
http://www.okayama-u.ac.jp/user/oma/index.html
言語
Japanese
著作権者
岡山医学会
論文のバージョン
publisher
査読
有り
Eprints Journal Name
joma