肝移植术中血栓弹力图和常规凝血监测指标相关性研究  

Correlation between thromboelastography and conventional blood coagulation monitoring in liver transplantation

作　　者：李兵[1] 姜一新[1] 张宇[1] 杜伟忠[1] 苏纲[1] 赵亚玲[1] 

机构地区：[1]昆明市第一人民医院麻醉科,650011

出　　处：《临床麻醉学杂志》2011年第4期340-342,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察肝移植术中血栓弹力图(TEG)和常规凝血监测指标的相关性。方法行肝移植手术的患者40例,分别于麻醉诱导后(T1)、无肝期10 min(T2)、新肝期后15 min(T3)、关腹前30 min(T4)四个时点测定静脉血Plt、凝血酶原时间(PT)、国际标准化比值(INR)、凝血酶时间(TT)、激活部分凝血酶时间(APTT)、纤维蛋白原(FIB)及动脉血TEG指标:反应时间(R)、血块形成时间(K)、角度(α)、最大振幅(MA)。结果 R与PT、INR、APTT成正相关(r分别为0.891、0.931、0.702,P<0.05或P<0.01),与FIB成负相关(r为-0.706,P<0.05)。α与PT、INR、APTT成负相关(r分别为-0.864、-0.844、-0.678,P<0.05或P<0.01)。MA与FIB、Plt成正相关(r分别为0.779、0.817,P<0.01),与PT、INR、APTT成负相关(r分别为-0.843、-0.829、-0.704,P<0.05或P<0.01)。结论肝移植术中TEG指标和常规凝血监测指标存在明显相关性。Objective To study the correlation between thromboelastography （TEG） and conventional blood coagulation monitoring in orthotopic liver transplantation. Methods Forty patients undergoing liver transplantation were studied. Venous and arterial blood samples were drawn for platelet count and determination of TT, APTT, PT, FIB and the values of TEG at 4 time points： after anesthesia induction, 10 mins at anhepatic period, 15 rain after reperfusion and 30 mins before closing. Results There was a positive correlation between R and PT, INR, APTT （r= 0. 891 or 0. 931 or 0. 702 and P〈0.01 or P〈0.01 or P〈0.05） while there was a negative correlation between R and FIB（r=-0. 706 and P%0.05）. There was a negative correlation between a and PT, INR, APTT（r=-0. 864 or -0. 844 or -0. 678 and P〈0.01 or P 〈 0.01 or P〈0.05）. There was a positive correlation between MA and FIB, platelet count（r=0. 779 or 0. 817 and P 〈 0.01） while there was a negative correlation between MA and PT, INR, APTT（r=- 0. 843 or -0. 829 or 0. 704 and P〈 0.01 or P〈0.01 or P〈0.05）. Conclusion A significant correlation exists between the values of TEG and conventional blood coagulation monitoring in orthotopic liver transplantation.

关 键 词：肝移植术 血栓弹力图 血凝检测 

分 类 号：R614[医药卫生—麻醉学]