血栓弹力图和传统凝血功能检查在颅脑损伤手术患者的应用  

Application of thrombelastography and conventional coagulation tests in surgical patients with craniocerebral injury

作　　者：顾向进[1] 王东[1] 张党林[1] 张亮[1] 周涛[1] 李帅[1] 

机构地区：[1]南京医科大学附属江宁医院神经外科,江苏省211100

出　　处：《江苏医药》2017年第8期540-543,共4页Jiangsu Medical Journal

摘　　要：目的探讨血栓弹力图(TEG)和传统凝血功能检查在颅脑损伤患者围手术期的应用价值。方法对40例单纯的、无休克的颅脑损伤患者围手术期同时(术前、术中2h、术后24h)行TEG和传统凝血功能检查监测,比较两者的相关性,综合考虑传统凝血功能检查和TEG结果指导成分输血。结果 TEG参数与传统凝血功能检查指标存在一定的相关性:R值与APTT和凝血酶原时间呈正相关(r=0.774和0.757,P<0.01);纤维蛋白原与α角呈正相关(r=0.614,P<0.01),与K值呈负相关(r=-0.840,P<0.01);MA值与Plt呈正相关(r=0.833,P<0.01)。对40例患者实施了针对性的成分输血,术后24h患者异常的凝血功能得到明显纠正。结论联合应用TEG和传统凝血功能检查可全面评估颅脑损伤患者围手术期的凝血功能状态,指导临床合理的成分输血。Objective To investigate the application value of thrombelastography（TEG）and conventional coagulation tests in surgical patients with craniocerebral injury.Methods The coagulation status was monitored using TEG and conventional tests at the same time points of before,at 2 hours during surgery and 24 hours after operation in 40 patients with craniocerebral injury without shock and other severe organ injuries.The correlation between the results reported by two methods was analyzed.Guided by overall consideration of the results from TEG and conventional tests,the patients were given component blood transfusions.Results The correlation between the results reported by two methods existed in a certain degree.R value was positively correlated with APTT and PT（r=0.774 and 0.757,P〈0.01）.Fib was positively correlated withαangle（r=0.614,P〈0.01）,but negatively correlated with K value（r=-0.840,P〈0.01）.MA value was positively correlated with platelet count（r=0.833,P〈0.01）.The abnormalities of coagulation status in 40 cases were corrected remarkably after component blood transfusions guided by overall consideration of the results from TEG and conventional coagulation tests.Conclusion Combined use of TEG and conventional tests can evaluate comprehensively the coagulation status and guide component blood transfusions rationally in surgical patients with craniocerebral injury.

关 键 词：血栓弹力图 凝血试验 颅脑损伤 

分 类 号：R651[医药卫生—外科学]