血栓弹力图在消化道大出血患者输血管理中的应用  

Application of thromboelastogram in blood transfusion management of patients with massive hemorrhage of gastrointestinal tract

作　　者：韦赐秋[1] 姜设初 WEI Ciqiu;JIANG Shechu(Department of Blood Transfusion,the People’s Hospital of Guigang City in Guangxi Zhuang Autonomous Region,Guigang 537100,China)

机构地区：[1]广西壮族自治区贵港市人民医院输血科

出　　处：《中国现代医生》2019年第26期99-102,共4页China Modern Doctor

摘　　要：目的评价血栓弹力图(Thrombelastography,TEG)在消化道大出血患者输血管理中的作用,为消化道大出血患者的输血管理提供参考。方法选择2016年2月~2018年8月于我院消化内科住院的140例消化道大出血患者,依据随机数字表法分为观察组和对照组各70例,两组均行常规凝血功能检测并实施输血管理,观察组加做TEG检测并指导成分输血。比较两组患者输血前和输血后24 h凝血功能变化及血制品使用情况。结果观察组和对照组输血后24 h的PT值、APTT值、TT值比输血前均下降,FIB值均上升,且观察组的指标变化更为明显,差异有统计学意义(P<0.05)。观察组输血后24 h的血栓弹力图检测的R值、K值较输血前明显下降,Angle值、MA值、LY30值、CI值较输血前明显上升,差异有统计学意义(P<0.05)。血制品使用情况,观察组FFP、RBC输注量低于对照组,CRYO、CP输注量高于对照组,差异有统计学意义(P<0.05)。结论根据TEG检测指导成分输血,可达到精准输血,快速改善患者凝血功能,减少FFP的使用量,与常规凝血功能检测相比,具有明显的优势。Objective To evaluate the role of thrombelastography(TEG) in blood transfusion management in the patients with massive hemorrhage of gastrointestinal tract, and to provide reference for blood transfusion management in the patients with massive hemorrhage of gastrointestinal tract. Methods A total of 140 patients with massive gastrointestinal hemorrhage who were admitted to the Department of Gastroenterology in our hospital from February 2016 to August 2018 were selected. According to the random number table method, the patients were divided into observation group and control group, with 70 cases in each group. Both groups were given routine coagulation function testing and blood transfusion management. The observation group was further given TEG testing and guided component blood transfusion. The coagulation function changes before blood transfusion and 24 hours after blood transfusion and blood product usage were compared between the two groups. Results The PT value, APTT value and TT value in the observation group and the control group 24 h after blood transfusion were decreased compared with those before transfusion, and the FIB value was increased. The changes in the indicators in the observation group were more significant, and the differences were statistically significant(P<0.05). The R and K values of thromboelastography at 24 h after blood transfusion in the observation group were significantly lower than those before blood transfusion. The Angle value, MA value, LY30 value, and CI value were significantly higher than those before blood transfusion, and the differences were statistically significant (P<0.05). The usage of blood products, the FFP and RBC infusion volume in the observation group were lower than those in the control group. The blood transfusion volume of CRYO and CP was higher than that in the control group, and the difference was statistically significant(P<0.05). Conclusion According to TEG testing and guided component blood transfusion, the accurate blood transfusion is achieved, the pat

关 键 词：血栓弹力图 凝血功能 消化道大出血 输血管理 

分 类 号：R457.1[医药卫生—治疗学] R61[医药卫生—临床医学]