目的：观察全麻手术患者术后血小板-白细胞聚集体（ PLA）的变化，探讨全麻手术患者深部静脉栓塞发生的机理。方法对112例全麻手术患者分别于麻醉诱导前、手术结束后、术后3 d采集标本，利用流式术检测血小板-粒细胞聚集体（ PNA）和血小板-单核细胞聚集体（ PMA），观察PNA和PMA的变化。结果112例全麻手术患者麻醉诱导前PNA为（19.32±3.48）％， PMA为（26.86±5.05）％；手术结束后PNA为（19.48±3.20）％，PMA为（31.86±5.31）％；术后3d PNA为（21.85±2.84）％，PMA为（77.69±5.72）％。麻醉诱导前的PNA和PMA与手术结束后、术后3 d比较差异均有统计学意义（ P＜0.01）。结论全麻手术对患者PNA和PMA均有影响，尤其对PMA影响明显，因此PNA和PMA可以作为判断血小板活化程度和预防术后栓塞的敏感性观察指标。%Objective To monitor the platelet-leukocyte aggregates ( PLA) level in patients received surgery under general anesthesia and to explore the potential mechanism of deep vein thrombosis occurred in these patients . Methods Blood samples were collected from 112 patients received surgery at the time:before the general anesthesia;immediately after the surgery , and 3 days after the surgery .Flow cytometry was used to measure the platelet-neutro-phil aggregates ( PNA ) and platelet-monocyte aggregates ( PMA ) .Results Before the general anesthesia: PNA (19.32 ±3.48)%, PMA(26.86 ±5.05)%;Immediately after the surgery:PNA(19.48 ±3.20)%, PMA(31.86 ± 5.31)%;Three days after the surgery:PNA(21.85 ±2.84)%, PMA(77.69 ±5.72)%; Statistical analysis: the PNA and PMA level in patients immediately after the surgery and that in patients three days after surgery were higher than that patients before the general anesthesia ( P<0.01 ) .Conclusion The PNA and PMA level , especially , the PMA level in patients received surgery is affected by general anesthesia .PNA and PMA can be used as a sensitive bi-omarker to determine the degree of platelet activation and to predict the possible postoperative thrombosis .
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