| Project/Area Number |
07457497
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Surgical dentistry
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| Research Institution | NIPPON DENTAL UNIVERSITY,SCHOOL OF DENTISTRY AT TOKYO |
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Principal Investigator |
TAKASUGI Yoshihiro NIPPON DENTAL UNIVERSITY,SCHOOL OF DENTISTRY AT TOKYO,ANESTHESIOLOGY,ASSISTANT PROFESSOR, 歯学部, 講師 (90120683)
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| Co-Investigator(Kenkyū-buntansha) |
ARAI Chiaki NIPPON DENTAL UNIVERSITY,SCHOOL OF DENTISTRY AT TOKYO,ANESTHESIOLOGY,INSTRUCTOR, 歯学部, 助手 (40139308)
NAKAMURA Kiminari NIPPON DENTAL UNIVERSITY,SCHOOL OF DENTISTRY AT TOKYO,ANESTHESIOLOGY,ASSISTANT P, 歯学部, 講師 (80139295)
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| Project Period (FY) |
1995 – 1996
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| Project Status |
Completed (Fiscal Year 1996)
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| Budget Amount *help |
¥7,400,000 (Direct Cost: ¥7,400,000)
Fiscal Year 1996: ¥900,000 (Direct Cost: ¥900,000)
Fiscal Year 1995: ¥6,500,000 (Direct Cost: ¥6,500,000)
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| Keywords | PROLONGED OPERATION / BLOOD COAGULATION-FIBRINOLYSIS SYSTEM / HEPARIN / HYPERCOAGULABILITY / 長時間麻酔 / 血液凝固活性 / 線溶活性 / 全身麻酔 |
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| Research Abstract |
Background : Although it is thought that prolonged operation is one of the factors to cause systematic hypercoaglability, the perioperative alternation of blood coagulation-fibrinolysis system has not been reported. The aims of this study were to clarify the changes of coagulation-fibrinolysis activity during prolonged operation and the effect of heparin therapy by using molecular markers.
Method : The subjects were the patients with oral cancer who underwent the operation which took more than 10 hours and included tumor excision and reconstruction using a free flap. The subjects were divided into two random groups, heparin group consisting of continuous intravenous heparin infusion which was administrated from the starting point of micro surgery to the end of anesthesia and control group ; without heparin therapy.
The dose of heparin was controlled by activated partial thromboplastin time (APTT) showing the range 50-70sec. We measured prothrombin time (PT), APTT,fibrinogen antithrombin
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III (ATIII), thrombin-antithrombin IIIcomplex (TAT), fibrinopeptide A (FPA), prothrombin fragment1+2 (F1+2), soluble fibrin monomer complex (SFMC), D-dimer, plasmin-a2 plasmin inhibitor complex (PIC) and heparin concentration from the stating point to the end point of anesthesia.
Result : Coagulation markerlevels increased remarkably depending on the progress of the operation in all cases of the control group, and 3 cases of control group showed the activation of fibrinolysis. In the heparin group, anticoagulant effect by heparin appeared clearly after the start of heparin infusion. Also 3 cases of heparin group showed the activation of fibrinolysis, but the degree of the activation was slighter than in control group. Heparin concentration was showing underneath 0.2U/ml, and there was slight crrelation between APTT and heparin concentration(r=0.62).
Conclusion : It is clear that blood coagulation-fibrinolysis system is activated from the early stage of prolonged operation, and continuous intravenous heparin infusion is effective as an anticoagulant therapy during operation. Less
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