血栓弹力图在妊娠合并血小板减少症患者中的应用效果  

Application effect of thrombus thrombelastogram in patients with pregnancy with thrombocytopenia

作　　者：宋鸿碧[1] 雷后康[1] 

机构地区：[1]贵州医科大学附属医院产科,贵州贵阳550004

出　　处：《中国医药导报》2015年第32期83-86,共4页China Medical Herald

摘　　要：目的探讨血栓弹力图在妊娠合并血小板减少症患者中的应用效果。方法选择2014年1月~2015年1月于贵州医科大学附属医院住院治疗的85例妊娠合并血小板减少症患者为研究对象,将其分为研究组（n=45）和对照组（n=40）。研究组患者入院后采用常规凝血功能检测及血栓弹力图联合评估患者的凝血功能,对照组患者仅给予常规凝血功能检测,并根据患者的凝血功能选择分娩方式。比较两组患者剖宫产率、阴道分娩率及术中、术后出血情况及实验室检测结果等。结果两组患者分娩前丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、凝血酶原时间、活动度、部分凝血活酶时间、凝血酶时间的比较,差异无统计学意义（P〉0.05）。研究组阴道分娩率明显高于对照组,剖宫产率明显低于对照组,差异有统计学意义（P〈0.05）;两组患者术中出血量、产后24 h出血量及产后大出血发生率比较,差异均无统计学意义（P〉0.05）。两组患者手术前后血小板、红细胞、血红蛋白组内比较,差异有统计学意义（P〈0.05或P〈0.01）,而两组血细胞比容（HCT）手术前后组内比较,差异无统计学意义（P〉0.05）。研究组剖宫产患者术前血小板、血红蛋白及HCT水平与阴道分娩者比较,差异无统计学意义（P〉0.05）;阴道分娩者K值、R值、α角、凝血综合指数（CI值）等血栓弹力图检测指标均明显优于剖宫产患者,差异均有统计学意义（P〈0.05）。结论血栓弹力图能准确评估妊娠合并血小板减少症患者的凝血功能,有助于正确选择分娩方式,降低剖宫产率,值得临床推广应用。Objective To explore the application effect of thrombus thrombelastogram（TEG） in patients with pregnancy with thrombocytopenia. Methods From January 2014 to January 2015 in the Affiliated Hospital of Guiyang Medical University（＂our hospital＂ for short）, 85 cases of pregnancy with thrombocytopenia were selected as the research objects,and they were divided into research group（n=45） and control group（n=40）. The blood coagulation function of patients in the research group were assessed after admitted to our hospital by the regular detection of blood coagulation function combined with TEG, while the control group was only given regular detection of blood coagulation function, the delivery way was selected according to the coagulant function of patients. The laboratory test results of patients in two groups,such as rate of cesarean section, vaginal births and intraoperative bleeding and postoperative bleeding were compared.Results Before delivery, ALT, AST, PT and PT, APTT, TT% of patients in the two groups had no statistically significant differences（P〉0.05）. The rate of vaginal delivery in the research group was significantly higher than that of the control group, the rate of cesarean section was significantly lower than that of the control group, the difference was statistically significant（P〈0.05）. The amount of bleeding, 24 hour postpartum blood loss and incidence of postpartum hemorrhage of two groups had no statistically significant differences（P〉0.05）. PLT, numbers of red blood cells, Hb of two groups before and after surgery were compared, the differences were statistically significant（P〈0.05 or P〈0.01）,and HCT of two groups before and after surgery had no statistically significant difference（P〉0.05）. Levels of PLT, Hb and HCT preoperative of patients with cesarean section and vaginal delivery had no statistically significant differences（P〉0.05）, while blood clots elastic figure detection index such as time of R, K, alpha angle, CI value of patients wi

关 键 词：血栓弹力图 妊娠合并血小板减少症 凝血功能 

分 类 号：R558.2[医药卫生—血液循环系统疾病]