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題 名 | Thromboelastographic Study of Thrombosis in the Implantable Central Venous Access Device=Thromboelastography對中央靜脈內植式輸液導管內發生栓塞之研究 |
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作 者 | 溫永銳; 侯文詠; 孫維仁; 柯子鴻; 葉明; 姚維正; 戴裕庭; | 書刊名 | 麻醉學雜誌 |
卷 期 | 35:4 1997.12[民86.12] |
頁 次 | 頁223-228 |
分類號 | 416.5 |
關鍵詞 | 血液凝固測試; 導管置放術:中央靜脈; Blood coagulation test:Thromboelastography; Catheterization:Central venous; |
語 文 | 英文(English) |
中文摘要 | 背景:Thromboelastography(TEG)優於其他的凝血測驗在於它可提供病患血液凝血 狀態全面性的評估,並可快速的得到分析結果。本實驗即利用TEG來研究癌症病患本身的凝 血異常現象是否與中央靜脈內植式輸液導管(Port-A-Cath, Pharmacia)裝設後的血管栓塞有關。 方法:所有76名病患在進行植入手術前先抽取靜脈血液並分析TEG的R時間值、α角度、 及MA值,其中11位病患(血栓組)是因先前的中央靜脈輸液導管發生栓塞而需重新安裝,另 65名(控制組)為首次裝設。最後將這些病人的凝血狀態依TEG數值分成凝血過強、凝血正常、 及凝血不足三種類型。 結果:我們發現血栓組病患均無凝血過強現象;控制組有5名病患(7.5%)顯示凝血過強, 但臨床上觀察三個月後並無血管栓塞出現。對TEG數值作分析,除在控制組的MA值高於血栓 組外(p<0.05), R值及α角度在兩組均無差別。此外,比較兩組血液的凝血狀態(控制組 vs. 血栓組)分別為:凝血過強(7.5% vs. 0)、正常(91.0% vs. 90.9%)、及凝血不足(15% vs. 9.1%), 但統計上均無差異(Fisher's exact test, P=0.229)。 結論:因此我們推論癌症病患本身的凝血過強狀態並不是造成中央靜脈內植式輸液導管 血管栓塞的主要原因。 |
英文摘要 | Background: In the present study thromboelastography (TEG) was to study whether or not hypercoagulopathy might contribute to the thrombosis of implantable central venous access device (Port-A-Cath, Pharmacia) in cancer patients. Methods: All 76 oncological patients who were enrolled in this study had their R time, α angle and MA value measured before Port-A-Cath implantation, of whom 11 patients received re-implantation because of thrombotic device. We compared the measurements of these 11 patients (thrombotic group) with that of 65 patients (control group) who received Port-A-Cath implantation for the first time. According to TEG values the hemostatic status in these patients was classified as hypercoagulable, normal or hypocoagulable for comparison. All patients in the control group were followed up for 3 months for occurrence of thrombosis. Results: ft was found that no patient in the thrombotic group was associated with hypercoagulopathy. Five patients (7.5%) in the control group was found in hypercoagulable status at the time of catheter insertion but none of them developed clinical thrombosis during three months of observation. There was no significant difference between the two groups for R time, α angle but a higher MA value was found in the control group (p <0.05). Furthermore, the hypercoagulability (7.5% for the control vs. none for the thrombotic group), hypocoagulability (1.5% vs. 9.1%) and normocoagulability (91.0% vs. 90.9%) were not statistically different between the two groups (Fisher exact test, P = 0.229). Conclusions: We conclude that hypercoagulopathy in cancer patients has little, if any, contribution in thrombosis of the implantable central venous access device. |
本系統中英文摘要資訊取自各篇刊載內容。