[Objective]To analyze the preventive effect of hemoglobin and prothrombin time monitoring on the risk of gas-trointestinal bleeding after aortic valve replacement in elderly patients with aortic stenosis.[Methods]A total of 76 patients with aortic stenosis who underwent aortic valve replacement in our hospital from May 20 1 6 to September 201 7 were enrolled in our hospital.Blood samples were collected from all selected patients at 12h (T0 ),intraoperative (T1 ),and 12h (T2 )after sur-gery.Hemoglobin was sampled from whole blood and immediately detected after collection.The detection method was high-performance liquid chromatography.Prothrombin time (PT)was measured using a Sysmex CA-7000 automated hemagglutina-tion analyzer.Statistical analysis of the resulting data was performed using software SPSS 16.0.[Results]The hemoglobin lev-els in the case group at T1 and T2 were significantly lower than those in the control group (P <0.05).The hemoglobin level at T1 was significantly lower than that at T0 (P<0.05).The hemoglobin level at T2 was significantly higher than that at T1 (P<0.05).The prothrombin time in the case group at T1 and T2 was significantly longer than that in the control group (P <0.05). The prothrombin time at T1 was significantly longer than that at T0 (P<0.05).Prothrombin time was significantly shorter than T1 (P <0.05).Patients with upper gastrointestinal hemorrhage had hemoglobin and prothrombin measured in three dif-ferent periods:12h (T0 ),intraoperative (T1 ),and 12h (T2 ).There was a negative correlation (P<0.05).There was a nega-tive correlation between hemoglobin and prothrombin levels during the intraoperative (T1 )period in patients without upper gastrointestinal hemorrhage (P<0.05),12 h before surgery (T0 ),and 12 h after surgery (P <0.05).[Conclusion]Periopera-tive hemoglobin and prothrombin time monitoring have a certain preventive effect on reducing the risk of gastrointestinal bleed-ing after aortic valve replacement in elderly patients with aortic stenosis.At the same time,patients with a focus on hemoglobin reduction and prothrombin time should be paid attention to during the detection process.Once the relevant postoperative com-plications occur,the cause and symptomatic treatment should be promptly performed.%[目的]探讨围术期血红蛋白(Hb)与凝血酶原时间(PT)监测评估在老年主动脉瓣狭窄患者主动脉瓣置换术后发生消化道出血风险的临床价值.[方法]选取 2016 年 5 月至 2017 年 9 月本院收治的 76 例行主动脉瓣置换术治疗的主动脉瓣狭窄患者临床资料,根据术后是否出现消化道出血将其分为观察组(n=16)和对照组(n=60).收集患者术前 12 h(T0 )、术中(T1 )、术后 12 h(T2 )三个不同时段的血液标本,其中 Hb以全血为样本,采集后立即检测,检测方法为高效液相色谱法;凝血酶原时间(PT)采用 SysmexCA-7000 全自动血凝分析仪进行测定.[结果]两组患者 T1 时 Hb 水平显著低于 T0 时,T2 时显著高于T1 时,观察组T1 、T2 时 Hb水平显著低于对照组,差异均有统计学意义(P <0.05).两组患者 T1 时 PT 大于 T0时,T2 时刻PT小于T1 时,观察组T1 、T2 时PT大于对照组,差异均有统计学意义(P <0.05).观察患者 T0 、T1 、T2 三个不同时段 Hb与PT水平均呈负相关(P <0.05);对照组患者T1 时 Hb与PT水平呈负相关(P <0.05),T0 、T2 时 Hb与PT水平无相关性(P >0.05).[结论]围术期 Hb与PT水平监测对于降低老年主动脉瓣狭窄患者主动脉瓣置换术后消化道出血风险的有一定的提示作用.在检测过程中应重点关注 Hb水平降低与PT水平升高的患者,一旦出现相关的术后并发症应及时进行病因和对症处理.
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