| Objective:To search the sensitive indicator predicting the incidence and development of CRT to reduce the harm caused by CRT,we established the models of indwelling vein catheter in external jugular vein of rabbits.Normal saline solution and 20%manntiol which were in common use in clinical therapy were transfused respectively.We observed the incidence rate of CRT and pathological changes of tissue surrounding the catheter under the action of different drugs and in different indwelling times.The concentrations of APTT?PT?FIB?TT?D-D and t-PA were detected before and after indwelling catheter to discuss the relationship between their changes and CRT.Methods:Seventy healthy big-eared rabbits were randomly divided into blank control group(n = 10),control group(n=30)and experimental group(n = 30).The blank control group accepted no special treatment,while control group and experimental group were transfused normal saline solution and 20%manntiol respectively after indwelling catheter.The latter two groups,according to indwelling times of 1,3 and 5 days,were divided into six groups of 10 rabbits each.Each animal of indwelling catheter was drew blood before and on the last day to detect the concentrations of APTT,PT,FIB,TT,D-D and t-PA,which could reflect the function of coagulation and fibrinolysis.And all the animals in the blank control group were detected the same things on the day before?the 1st?3rd?5th day of indwelling catheter.The animals were sacrificed on the last indwelling day,and the veins punctured were removed and fixed in formalin.Thrombosis and pathological changes of surrounding tissue were performed by using standard light microscopy on hematoxylin-eosin stained specimens.Results:1.It was easy to cause damage to the blood vessels and surrounding tissues after indwelling vein catheter,and the incidence rate of CRT was 98.33%(59/60).These changes were associated with indwelling catheter(P<0.001),but they had little to do with the type of inputting drugs(P>0.05).2?The CRT was associated with indwelling time.In mannitol group,the degree of CRT is the mildest on the first day when compared with the 3rd day and the 5th day.The difference was statistically significant(P=0.004;P=0.013).There were no statistically significant differences between the indwelling time and incidence of CRT in normal saline group,but the degree of CRT on the 3rd day was slightly serious than the other two time periods.3?Whether in the same group but different indwelling times or in the same indwelling times but different group,there were no statistically significant differences among all the indicators of coagulation and fibrinolytic except FIB.4?There was no statistically significant difference in FIB in different indwelling times of blank group;But in normal saline group and mannitol group,the concentration of FIB began to rise after indwelling catheter,and reached thepeak on the 3 rd day.Although it declined slightly on the 5 th day,the concentration of FIB was still higher than that before indwelline catheter.5.The concentration of FIB was positively related to CRT,and the correlation coefficient was 0.295,P=0.015;The concentration of t-PA was negatively related to CRT,and the correlation coefficient was-0.264,P=0.030.The degree of CRT was most serious on the 3rd day when the concentration of FIB was maximum while t-PA was minimum at the moment.Conclusions:1?It was easy to cause occurrence of CRT after indwelling vein catheter,which would cause the rise of FIB and reducing of t-PA.2?The 3rd day after indwelling catheter was the high-risk stage of occurrence of CRT.At this moment,the body was often in the state of hypercoagulability and low fibrinolytic activtity.3.It could provide criterion to judge the occurrence of CRT when monitoring the changes of concentration of FIB and t-PA. |
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