Factors Relating to Coagulation, Fibrinolysis and Hepatic Damage After Liver Resection

摘要

A survey of the blood of twenty-two patients who had undergone hepatic resection was performed.Serum levels ofα-2 plasmin inhibitor-plasmin complex initially decreased from 1.58 ± 0.31μg/ml on the preoperative day (PREOP), to 0.92 ± 0.14μ/ml on the first postoperative day (POD 1), and then increased to 3.13 ± 0.92μg/ml on the seventh postoperative day (POD 7) (mean ± SE)). Thrombin-anti-thrombin III complex (14.2 ± 4.3 ng/ml on PREOP and 26.0 ± 4.1 ng/ml on POD 7(mean ± SE)) and D-dimer (335 ± 96 ng/ml on PREOP and 1859 ± 258 ng/ml on POD 7 (mean ±SE)) increased in the early postoperative stage. The level of 6-keto-prostaglandin F1αincreased afterthe operations (from 13.2 ± 1.8 pg/ml on PREOP to 37.8 ± 12.8 pg/ml on POD 7 (mean ± SE)). Thelevel of thromboxane B-2 decreased at first, and then gradually increased and returned to itspreoperative level on POD 7 (144.7 ± 43.8 pg/ml on PREOP, 57.6 ± 27.5 pg/ml on POD1 and 152.5± 58.4 pg/ml on POD 7 (mean ± SE)). Superoxide dismutase activity increased at first, and thengradually decreased, postoperatively (2.8 ± 0.5 NU/ml on PREOP, 4.8 ± 0.8 NU/ml on POD1 and 2.6± 0.3 NU/ml on POD 7 (mean ± SE)). That is, biodefensive reactions which protect patients againstthe shift to disseminated intravascular coagulation (DIC) were inferred with by the increase in antiplateletaggregation, despite the activation of coagulation and fibrinolytic mechanisms after hepaticresection.