肝素酶纠正的血栓弹力图在胸心外科患者术后的应用  

Application of heparinase-modified thromboelastography in postoperative patients of cardiothoracic surgery

作　　者：赵凌[1] 张敏[1] 徐智杰[1] 李莺[1] 周小玉[1] 

机构地区：[1]南京医科大学第一附属医院输血科,南京210029

出　　处：《临床检验杂志》2014年第11期825-827,共3页Chinese Journal of Clinical Laboratory Science

基　　金：南京市科技计划项目(201303037)

摘　　要：目的评价肝素酶纠正的血栓弹力图(hm TEG)在胸心外科患者术后的应用价值。方法选择268例胸心外科患者,在胸心外科手术后检测普通TEG和hm TEG,两组结果分别进行配对t检验。其中,31例患者同时检测了活化凝血时间(ACT),将ACT值与hm TEG各参数进行相关性分析。结果普通TEG和hm TEG各参数比较,最大振幅(MA)差异未见统计学意义(P>0.05),R、K、Angle和CI(凝血综合指数)差异均有统计学意义(P<0.05)。ACT与K、△R呈正相关,r分别为0.500、0.536,P<0.05;ACT与Angle、MA、CI呈负相关,r分别为-0.383、-0.323、-0.334,P<0.05;ACT与R不相关。结论hm TEG在监测胸心外科患者术后的凝血功能及判断肝素残留方面具有一定价值。Objective To evaluate the clinical application of heparinase-modified thromboelastography （hmTEG） in the postoperative patients of eardiothoraeic surgery. Methods A total of 268 patients undergoing thoracic surgery were included in our study in which TEG and hmTEG were simultaneously assayed for the patients after operation. The significances of the both tests were analyzed with paired t-test. The activating clotting time（ACT） was tested in 31 patients after operation. The correlation between the values of ACT and hmTEG was analyzed. Results Comparing the results of TEG with those of hmTEG, the values of R, K, angle and clotting index （CI） exhibited significantly statistical difference（P 〈0.05） except for MA value（P 〉0.05）. The values of ACT showed significantly positive correlation with the values of K and △ R, and the correlation coefficients were 0.500 and 0. 536 respectively（ P 〈 0.05 ）. The negative correlations of the values of ACT with angle, MAand CI were found and the correlation coefficients were - 0. 383, - 0. 323 and -0. 334 respectively（ P 〈 0. 05 ）. No correlation between the values of ACT and R was shownand the correlation coefficient was 0. 138. Conclusion Heparinase-modified thromboelastography（hmTEG） should be more valuable in monitoring the blood coagulation function and assessing the heparin residues in the postoperative patients with thoracic surgery.

关 键 词：胸心外科 血栓弹力图 肝素酶纠正 活化凝血时间 肝素残留 

分 类 号：R446[医药卫生—诊断学]