血栓弹力图在指导肝癌患者术后临床输血中的意义  

The significance of thromboelastography in guiding clinical transfusion in liver cancer patients after operation

作　　者：邵树军 蒙博 王斯雅 孙萍 刘宗健 郝新建 王艳 

机构地区：[1]郑州大学附属肿瘤医院,河南郑州450008 [2]河南省疾病控制中心

出　　处：《中国输血杂志》2016年第5期500-502,共3页Chinese Journal of Blood Transfusion

基　　金：河南省医学科技攻关计划项目(NO:2011020167)

摘　　要：目的探讨血栓弹力图(TEG)在指导肝癌患者术后临床输血中的意义。方法将82名术后凝血功能异常的肝癌患者随机分为2组:依据凝血4项和血小板计数结果指导临床输血者设为对照组,依据TEG的实验数据指导临床输血者设为实验组,每组各41名患者。2组患者在输血前及输血后24 h进行检测凝血4项和血小板计数实验,观察2组患者的出血或渗血量及出血或渗血时间、不同血液成分的使用量。结果实验组患者的凝血功能异常改善状况好于对照组(P<0.05)。对照组和实验组患者CRC、FFP、CRYO、PC的使用量,出血或渗血时间及量分别为(4.35±2.29)U,(350.25±66.67)m L,(14.12±3.84)U,(1.26±0.06)治疗量、(32.49±6.02)h,(302.21±71.25)m L和(3.42±1.87)U,(289.59±57.42)m L,(16.45±4.15)U,(1.31±0.08)治疗量、(25.91±4.03)h,(238.49±43.26)m L。与对照组相比,实验组CRC及FFP使用量和出血或渗血量减少、出血或渗血时间缩短(P<0.05)。2组CRYO、PC使用量基本持平(P>0.05)。结论肝癌患者术后应用TEG指导输血能显著减少出血或渗血量及出血或渗血时间,降低部分血液制品的使用量,是围术期较为理想的输血指导方法。Objective To investigate the significance of thromboelastography（ TEG） in guiding clinical transfusion in liver cancer patients after operation. Method 82 cases of patients with liver cancer were randomly divided into two groups：each group was consisted of 41. The control group was guided on clinical transfusion with the use of PT,APTT,TT,FIB and Plt.The test group applied TEG. Blood samples were detected before the transfusion and 24 hours after the transfusion. The hemorrhagic conditions of patients,the duration of hemorrhage and the amount of blood transfused,were observed. Result PT,APTT,TT,FIB and Plt were better in test group than control group（ P〈0. 05）. The use of CRC,FFP,CRYO,PC,the duration of haemorrhage and stasis,the amount of haemorrhage and stasis were（ 4. 35 ± 2. 29） U,（ 350. 25 ± 66. 67） m L,（ 14. 12 ± 3. 84） U,（ 1. 26 ± 0. 06） U,（ 32. 49 ± 6. 02） h,（ 302. 21 ± 71. 25） m L,respectively in the control group. In the test group,these values were（ 3. 42 ± 1. 87） U,（ 289. 59± 57. 42） m L,（ 16. 45 ± 4. 15） U,（ 1. 31 ± 0. 08） U,（ 25. 91 ± 4. 03） h,（ 238. 49 ± 43. 26） m L. Compared with the control group,the amount of haemorrhage and stasis,CRC and FFP decreased significantly in the test group,while the time of haemorrhage and stasis were short in test group（ P〈0. 05）. The amount of PC and CRYO were not significantly different in the two groups（ P〉0. 05）. Conclusion The application of TEG-guided transfusion strategy can reduce the risk of hemorrhage and the amount of transfusion in liver cancer patients after operation.

关 键 词：血栓弹力图 肝癌患者 临床输血 

分 类 号：R735.7[医药卫生—肿瘤] R457.1[医药卫生—临床医学]