骨椎体、椎骶肿瘤手术患者血栓弹力图检测结果与围术期用血量相关性  

Relationship between TEG testing results of sacral vertebral body tumor patients and the perioperative use of blood

作　　者：陈波[1] 刘银[1] 刘业[1] 周晔[1] 唐晓峰[1] 

机构地区：[1]第二军医大学附属二院输血科,上海200003

出　　处：《中国输血杂志》2014年第8期822-825,共4页Chinese Journal of Blood Transfusion

基　　金：上海市公共卫生重点学科建设计划资助项目(12GWZX0202)

摘　　要：目的探讨血栓弹力图(TEG)检测骨椎体、椎骶肿瘤患者体内凝血状态的应用效果。方法用TEG测定372名骨椎体、椎骶肿瘤患者的凝血象,以检测结果高凝、低凝及正常图像状态分成实验组1、2、3组,对照组25人为正常健康献血者;结合患者术前凝血象的检测结果,及肿瘤切除围手术期用血量的状况,了解患者凝血功能情况。结果实验组TEG高凝状态(1组)占37.10%(138/372)、低凝状态(2组)占5.38%(20/372)、正常图像状态(3组)占57.53%,与患者的围手术期输血量(悬浮红细胞)有着直接相关性;实验组患者的凝血象(除TT之外)、D-D检测结果都呈现异常现象,与患者的TEG高、低凝状态结果无直接相关性(P>0.05)。实验结果证实了TEG检测实验1组、2组与对照组之间有明显差异(P<0.01),3组与对照组之间无明显差异(P>0.05)。结论临床可根据术前TEG的检测结果来判断骨椎体、椎骶患者围手术期用血量的状态,正确估算、申请围手术期备血量。Objective To investigate the applicative effect of thromboelastography （TEG） in detection coagulation state of sacral vertebral body tumor patients . Methods Blood coagulation state of 372 sacral vertebral body tumor patients were measured by TEG. Patients were divided into three groups according to test results （ high pour point group, low pour point group and normal image state group） ,25 healthy donors were recruited as the control group. Combined with the testing results before operation,tha amount of blood used during perioperational period＇was analyzed. Results Patients with TEG-proven hypereoagulability （ group 1 ）, hypocoagulability （ group 2 ） and, normal image （ Group 3 ） accounted for 5.38 % （ 20/372 ）, 37.10% （138/372）, and 57.53%. of the whole experimental population. The amount of blood （red blood cell ） transfused perioperationaUy had a direct correlation with the ＇lEG test results. The coagulation test results （except for TT） and the re- suits of D-D showed abnormalities, which were not correlated with TEG-proven coagulation state. Experimental results demon- strated that the TEG-deteeted results in experiment group 1 ,group 2 and control group had significant difference （P 〈 0. 01 ） while the difference between group3 and the control group was not statistically significant（ P 〉 0. 05 ）. Conclusion We can use the results of preoperative TEG results to predict perioperative use of blood and correctly estimate, and apply periopera- tional preparation of blood.

关 键 词：血栓弹力图 骨肿瘤 骨椎体 椎骶 围术期输血 用血量 相关性 

分 类 号：R457.1[医药卫生—治疗学] R738.1[医药卫生—临床医学]