血栓弹力图在血浆输注中的应用  

Applying of Thromboelastography in Plasma Transfusion

作　　者：蒋光明[1] 王敏[1] 郑辉[2] 姚萍[1] 周建华[1] 王保龙[1] 

机构地区：[1]安徽省立医院输血科,合肥230001 [2]安徽省立医院检验科,合肥230001

出　　处：《临床输血与检验》2010年第2期115-118,共4页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探讨血栓弹力图(TEG)在非血液病患者手术后凝血功能监测中的应用价值;并根据检测结果对术后患者输注新鲜冰冻血浆(FFP)的疗效进行评估。方法选择非血液病患者38例,于术后输注FFP前、输注200 ml及输注400ml FFP后分别进行TEG及传统凝血象检测。对两种实验方法的结果进行分析,并对3种状态下TEG检测结果进行比较。结果在输注FFP前、输注200 ml及输注400 ml FFP后3种状态下,R时间、K时间、Angle值及凝血综合指数CI值的差异有统计学意义(F值分别为23.405、20.869、19.978和31.243,P值均<0.01),但最大振幅(MA)值在上述3种情况下的差异没有统计学意义(F=1.651,P>0.05)。3种状态下,PT、APTT、纤维蛋白原含量及凝血酶时间的差异均有统计学意义(F值分别为5.374、8.382、117.049和23.029,P值均<0.01)。3种状态下凝血象与TEG-CK检测结果比较,显示2种检测方法的差异有统计学意义(χ2=4.433,P<0.05)。结论TEG适用于患者术后凝血功能监测。TEG结果显示,输注不同量FFP后患者凝血功能得到显著改善。Objective This study was conducted to discuss the applying value of thromboelastograghy（TEG）,in monitoring postoperative coagulative function of non-hematonosis patients.Meanwhile,the curative effect of fresh frozen plasma（FFP） was evaluated according to the TEG results.Methods 38 cases of patients,without hematopathies,were screened.Postoperative TEG and coagulogram tests were carried out under 3 kinds of conditions： before FFP transfusion,after 200 ml and 400 ml of FFP transfused.Then comparative analyses between the detecting results of the 2 kinds of tests were performed,so did the TEG results of 3 kinds of conditions.Results Under 3 kinds of conditions： before FFP transfusion,after 200 ml and 400 ml of FFP transfused,the differences of R-time,K-time,Angel and CI were all statistically significant（F=23.405,20.869,19.978 and 31.243 respectively,all P〈0.01）,but the difference of MA was not statistically significant（F=1.651,P〉0.05）.The differences of PT,APTT,fibrinogen concentration and thrombin time under 3 kinds of situations were all of statistical significance,too（F=5.374,8.382,117.049 and 23.029 respectively,all P〈0.01）.There was also statistical difference between the results of 2 kinds of tests（χ^2=4.433,P〈0.05）.Conclusions TEG was suitable for monitoring coagulative function of postoperative patients.The TEG results showed that the postoperative patients′ coagulative function was improved obviously after transfusion of FFP.

关 键 词：血栓弹力图 新鲜冰冻血浆 输血 凝血象 

分 类 号：R457.1[医药卫生—治疗学]