TEG检测在急性百草枯中毒患者救治中的应用价值  

Application value of TEG detection in the treatment of acute paraquat poisoning patients

作　　者：徐路琼 贺坤华 胡映峰 巴雪娇 马丽琼[1] XU Lu-qiong;HE Kun-hua;HU Ying-feng(Department of Blood Transfusion, Furman Qujing First People＇ s Hospital, Qujing 655000, Chin)

机构地区：[1]云南省曲靖市第一人民医院输血科,655000

出　　处：《中国实用医药》2018年第17期37-39,共3页China Practical Medicine

摘　　要：目的探讨血栓弹力图(TEG)肝素酶对比实验在急性百草枯(PQ)中毒患者救治中的应用价值。方法 9例PQ中毒患者,在连续性血液净化治疗后进行TEG肝素酶对比检测,并记录血液净化治疗过程中和治疗后有无出血及血凝块形成。结果首次血液净化治疗后,肝素酶对比实验提示有肝素存在(或起效)4例;无肝素存在(或未起效)3例,静脉壶发现血凝块而终止治疗;肝素过量2例,1例在不出血的情况下立即行血液净化治疗,未采用肝素抗凝,另1例出血明显,血红蛋白(Hb)下降,选择输注红细胞和新鲜冰冻血浆,用鱼精蛋白中和肝素,出血停止,R值恢复正常。结论在急性PQ中毒患者救治中,可根据TEG肝素酶对比实验结果调整下一次血液净化肝素或低分子肝素用量,防止出现凝血或抗凝过度。Objective To investigate the application value of thrombelastography（TEG） heparinase contrast test in the treatment of acute paraquat（PQ） poisoning patients. Methods A total of 9 patients with PQ poisoning were compared with PEG heparanase after continuous blood purification, and blood and blood clot formation were recorded during the treatment of blood purification and after treatment. Results After the first blood purification treatment, heparanase contrast experiment showed that heparin existed（or acted on） in 4 cases, heparin did not exist（or did not work） in 3 cases and the treatment was stopped due to finding of blood clots in the vein pot. Heparin overdose in 2 cases, of which 1 case received blood purification treatment immediately without blood loss, no heparin anticoagulation was performed, another 1 case with significant bleeding and decreased hemoglobin（Hb）. Infusions of red blood cells and fresh frozen plasma were performed, and heparin was neutralized with protamine. Hemorrhage stopped and R values returned to normal. Conclusion In the treatment of patients with acute PQ poisoning, the dosage of next blood purification of heparin or low molecular weight heparin can be adjusted according to the TEG heparinase contrast experiment results to prevent the occurrence of coagulation or anticoagulation.

关 键 词：百草枯中毒 血栓弹力图 肝素酶对比实验 血液净化 

分 类 号：R595.4[医药卫生—内科学]