Effect Of A Preoperative Single Target Dose Of Fibrinogen On The Bleeding And Coagulation Function Of The Orthopaedic Surgery

Objective : To observe the effect of a preoperative single target dose of fibrinogen on the bleeding and coagulation function, and if CR is correlated with FIB, and to seek a fibrinogen predictive indicators in the body, this experiment selected the patients of the lumbar disc surgery with the surgery that posterior lumbar interbody fusion. Methods: On the basis of preoperative fibrinogen concentration, 60 cases with lumbar intervertebral disc herniation( LDH) were divided into two groups : normal control group( FIB≥3.0g/L, NC group,n=20), low FIB concentration group( FIB<3.0g/L,n=40). Low FIB concentration group was randomly divided into 2 groups: the control group( LC group,n=20),preoperativea single dose of FIB group(PF group, n=20). After anesthesia induction, the group PF was given the dose of FIB(g), the target concentration of FIB was set as 4g/L. the group NC, LC were given blank saline 100 ml, TO observe the change of coagulation Index for patients and the indicators of sonoclot before(before infusion) and after(after infusion) given the fibrinogen or saline solution. Results: Atthe time of after infusion: significant difference of FIB concentration was observed in group NC, LC, PF, group PF(3.8+0.2)>group NC(2.6+0.3)>group LC(2.2 +0.2);significant difference of CR was observed in group NC 、 LC 、 PF, group PF( 21.4+7.1)> group NC(16.2+5.6)> group LC(13.2+5.6). The comparion of theamount of bleeding: significant difference was observed in group NC, LC, PF, group PF( 516.74 +135.53)< group NC(660.71+119.34) < group LC(726.72+160.47).Conclusion: a preoperative single target dose of fibrinogen can effectively improve the fibrinogen concentration, improve blood coagulation, reduce intraoperative blood loss. CR value increased with the increasing of fibrinogen concentration, strong acumen to fibrinogen concentration change.