Coagulation studies in the patients with hepatocellular carcinoma before and after liver resection.
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概要
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In order to investigate the influence of hepatic resection on hemostasis, coagulation studies were carried out in patients with hepatocellular carcinoma. Twenty-nine patients were divided into 2 groups designed as group A which underwent 2 segmentectomy or more (13 patients) and group B which underwent 1 or less than a segmentectomy (16 patients).Preoperative studies of both groups revealed almost normal coagulation studies except for minor degree of thrombocytopenia, but liver function tests were slightly impaired. Postoperative studies revealed thrombocytopenia, prolonged PT, decreased levels of factor II, V, VII, IX, X, fibrinogen, plasminogen, AT-III and α2-M and increase of FDP. Seven out of the 29 patients showed positive ethanol gelation test in their postoperative course. These findings were more prominent in group A compared with group B and recovery of the levels of factor II, V, VII, IX, X, plasminogen and AT-III to the preoperative levels were significantly delayed in group A.Increased FDP and positive ethanol gelation test which generally indicate presence of hypercoagulability improved proportionally to the recovery of coagulation abnormalities. DIC was confirmed only in one out of 29 patients by the clinical and laboratory findings.Consequently coagulation disorders seen in the postoperative period of liver resection are mostly due to impaired liver functions which include impaired synthesis and RES clearance.
- 一般社団法人 日本血栓止血学会の論文
一般社団法人 日本血栓止血学会 | 論文
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