关键词:

重症肝炎 ；肝移植 ；围术期 ；凝血功能管理 ,

Abstract:

Objective To investigate the observation and management of blood coagulation function inpatients with severe hepatitis during perioperative period of liver transplantation. Methods The blood coagulation functions of 39 patients with severe hepatitis who underwent allogeneic liver transplantation in our hospital fromJanuary 2018 to March 2021 were retrospectively analyzed. Blood coagulation markers, such as thrombin time（PT），prothrombin time activity（PTA），international standardized ratio（INR），platelet count（PLT），thrombin time（TT）， fibrinogen（FIB）and activated partial thromboplastin time（APTT）, were measured before transplantation（T0），3 hours after transplantation（T1），24 hours after operation（T2）and 72 hours after operation（T3）. The dosage of clotting substance，operation time，volume of blood loss and volume of blood products during liver transplantationwere recorded. Results Compared with preoperative values，the values of PT and APTT decreased gradually afterthe use of coagulant substances（P ＜ 0.05），and returned to normal 72 hours after operation. The values of PTA and FIB gradually increased into the normal range after the use of coagulant substances（P ＜ 0.05）. Conclusion Thecoagulation function of the patients with severe hepatitis is poor，and the operation time of livertransplantation islong and complicated. It is of great significance to closely observe the bleeding of the patients，monitor the bloodcoagulation function and supplement the corresponding coagulation substances in time to ensure the smooth progress of the operation. 

Key words:

Severe hepatitis , Liver transplantation , Perioperative period , Blood coagulation management