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Purpose: by selecting elderly patients undergoing elective abdominal surgery, observed the impact of different anesthesia methods on different time points of perioperative prothrombotic status indicator changes, to explore whether different anesthetic methods involved in possible risk factors for perioperative stroke occurred. Methods: A prospective randomized controlled clinical study. Select ASA Ⅰ - Ⅱ grade elective abdominal surgery in elderly patients 24 cases, patients had no preoperative cardiopulmonary cerebral complications, were randomly divided into three groups: general anesthesia combined with epidural anesthesia group (A, n = 8), the the mere general anesthesia group (B, n), epidural anesthesia group (C group, n = 8). A group propofol total intravenous anesthesia combined with epidural block, postoperative patient-controlled epidural analgesia (PCEA), the epidural anesthesia choose 0.375% bupivacaine; B group with propofol total intravenous anesthesia, postoperative patient-controlled intravenous analgesia (PCIA); C group alone epidural anesthesia, epidural anesthesia use 0.5% bupivacaine. Before induction (T 1 ), anesthesia-induced (T 2 ) (C group for the surgery began instantly), operation, instantly (T < / sub>), postoperative 72h (T 4 ) venous blood, to detect the parameters reflect endothelial injury vWF factor, coagulation parameters the FIB, the anticoagulant parameters of TAT, fibrinolysis parameters D- dimer level changes. Results: (1) of vWF: comparison between each time point level for the group: the T 2 B group content is higher than A, group B while in group C, T 3 higher than the C group, no significant difference in the A and C groups. Each time point within each group group showed no significant difference. (2) FIB: each time point level for the group found: no significant difference between the three groups at each time point group; A group each time point, L 4 the FIB levels of higher than another three time points, C group at each time point comparison T 4 content is higher than T2, and T3, (3) D-dimer: Comparison between groups of the level of each time point found: the T 2 D-dimer levels in group B than in group A, within each group at each time point comparison A group T the 4 D- dimer levels were higher than that of the other three time points in group B T 2 D-dimer levels higher than that of the other three time points; (4) the TAT: three groups at each time point between groups the difference was not significant, three groups each group at each time point were no significant differences. Conclusion: Compared to general anesthesia, general anesthesia combined with epidural anesthesia and epidural anesthesia used in elderly patients undergoing abdominal surgery, can reduce vascular endothelial injury caused by surgical stress, reduce platelet activation and reduce perioperative hypercoagulable state in elderly patients, but no significant improvement in the fibrinolytic state. Help maintain a dynamic balance of the patient's coagulation, fibrinolytic, anticoagulant system, to reduce the risk factors for perioperative stroke occurred.
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