血栓弹力图(TEG)对颅脑损伤患者血液输注评估的意义  

Application of thromboelastography in patients with brain injury

作　　者：陈诚[1] 张敬军[1] 张琦[1] 朱鑫方[1] 夏荣[1] 

机构地区：[1]复旦大学附属华山医院输血科,上海200040

出　　处：《中国输血杂志》2015年第8期947-949,共3页Chinese Journal of Blood Transfusion

摘　　要：目的探讨血栓弹力图(TEG)对颅脑损伤患者血液输注评估的意义。方法回顾分析自2013年12月-2015年6月收治入院后<24 h进行TEG检测的96位颅脑损伤患者,以检测结果将96位患者分为高凝组、低凝组、正常组3组,并加设对照组12人(来源于正常健康志愿者),对比TEG与传统凝血实验的检测结果,了解颅脑损伤患者的凝血状态。结果 TEG检测高凝组(41/96)和低凝组(10/96)结果与对照组比较均存在统计学差异(P<0.05);正常组(45/96)与对照组比较无统计学差异(P>0.05);TEG检测下不同凝血状态颅脑损伤患者的凝血实验比较,高凝组中只有参数FIB存在差异(P<0.05);低凝组中只有参数PT和APTT存在差异(P<0.05);参数MA在不同输血量的组别中均存在显著差异,(P<0.01)。结论 TEG比常规凝血实验的敏感度更高,能够更有效区分出颅脑损伤患者的凝血状态,并且对患者的输血量有一定的预估和指导作用。Objective To investigate clinical value of Thromboelastography in brain injury patients. Methods Ninety six brain injury patients detected from TEG analysis within 24 hours after the December 2013 - June 2015 were recalled and admitted to hospital. These .patients were divided into three groups： hypereoagulable group, hypoeoagulable group and the normal groups. A control group of 12 people （from normal healthy volunteers） was set up. Test results from TEG and coagu- lation experiments were analyzed to understand the patient~ coagulation status following traumatic brain injury. Results TEG detected the hypercoagulable group （41/96） and hypocoagulable group （10/96）. Compared with control group, there were significant differences （ P 〈 0. 05 ）. There was no significant difference between normal group （ 45/96 ） and control group （ P 〉 0. 05 ）. Experimental comparison on different clotting coagulation status following TEG detection on brain injury patients, only hyper eoagulable group showed statistical differences on the parameter FIB （P 〈 0. 05 ）. For hypo coagulable group, only differences on parameters PT and AFIT were significant （P 〈 0. 05 ）. Parameter such as MA was significantly different when different amounts of blood were used for transfusion （ P 〈 0. 01 ）. Conclusion Compared with coagulation tests, TEG can more effectively distinguish the coagulation status of the brain injury patients, and can better provide more accurate estimates and guidance on the amount of blood for clinieal usage.

关 键 词：血栓弹力图 颅脑损伤 凝血功能 

分 类 号：R457.1[医药卫生—治疗学]