产妇血栓弹力图凝血综合指数的影响因素分析  

Analysis of influencing factors on blood coagulation composite indexes of maternal thromboelastography

作　　者：刘小华[1] 吕志英[2] 欧阳琳[2] 张子晖[1] 李云[1] 张仁秀 LIU Xiao-hua;LYU Zhi-ying;OUYANG Lin;ZHANG Zi-hui;LI Yun;ZHANG Ren-xiu(Blood Bank,People′s Hospital of Xingguo County,Jiangxi Province,Xingguo 342400,China;Clinical Laboratory,People′s Hospital of Xingguo County,Jiangxi Province,Xingguo 342400,China)

机构地区：[1]江西省兴国县人民医院血库,江西兴国342400 [2]江西省兴国县人民医院检验科,江西兴国342400

出　　处：《中国当代医药》2020年第8期32-36,共5页China Modern Medicine

基　　金：江西省赣州市指导性科技计划项目(GZ2018ZSF 623)。

摘　　要：目的探讨不同妊娠期孕妇的血栓弹力图参数情况,分析产妇产后出血的影响因素。方法选取2018年1月~2019年2月我院收治的128例产妇作为妊娠组,入组产妇均无妊娠并发症,根据生产时是否发生产后出血,将妊娠组产妇分为两组,分别为产后未出血组(90例)和产后出血组(38例)。并选取同期来我院进行孕期检查的90例不同孕期孕妇进行研究,根据孕龄不同将其分为早孕组(30例)、中孕组(30例)、晚孕组(30例)。选择同期来我院接受健康体检的30例非孕期健康者作为未孕组。检测分析各组的血栓弹力图相关参数,分析血栓弹力图凝血综合指数在产后出血中的参考价值,观察研究对象的凝血功能、血栓弹力图指标,对影响产妇产后出血的相关因素进行分析,并采用多因素回归分析其独立危险因素。结果妊娠组的血栓弹力图指标凝血启动阶段凝血时间(R值)、凝块生成速率(K值)低于未孕组,差异有统计学意义(P<0.05)。妊娠组的血栓弹力图指标纤维蛋白原功能(Angle角)、血小板功能(MA值)以及综合溶血指数(CI值)高于未孕组,差异有统计学意义(P<0.05)。晚孕组的血栓弹力图指标R值、K值低于中孕组及早孕组,差异有统计学意义(P<0.05)。晚孕组的血栓弹力图指标Angle角、MA值以及CI值高于中孕组及早孕组,差异有统计学意义(P<0.05)。中孕组的血栓弹力图指标R值、K值低于早孕组,差异有统计学意义(P<0.05)。中孕组的血栓弹力图指标Angle角、MA值以及CI值高于早孕组,差异有统计学意义(P<0.05)。单因素分析结果提示,产后出血组的血栓弹力图指标R值、K值高于产后未出血组,差异有统计学意义(P<0.05),产后出血组的血栓弹力图指标Angle角、CI值低于对照组,差异有统计学意义(P<0.05)。Logistic多因素回归分析结果提示,影响产妇产后出血的影响因素包含血栓弹力图指标R值(β=2.015,OR=13.853,95%CI:8.876~15.243)、KObjective To investigate the parameters of thromboelastic of pregnant women in different pregnancy periods and analyze the influencing factors of postpartum hemorrhage.Methods From January 2018 to February 2019,128 pregnant women admitted to our hospital were selected as the pregnancy group.All the pregnant women had no pregnancy complications.Based on whether they had postpartum hemorrhage during delivery,pregnant women in the pregnancy group were divided into two groups,namely,the group without postpartum hemorrhage(90 cases)and the group with postpartum hemorrhage(38 cases).Moreover,90 cases of pregnant women with different pregnancies who came to our hospital for pregnancy examination at the same time were selected for the study.According to their different gestational ages,they were divided into the early pregnancy group(n=30),the middle pregnancy group(n=30),and the late pregnancy group(n=30).Thirty non-pregnant healthy physical who came to our hospital at the same time for physical examination of antagonism were selected as the non-pregnant group.The related parameters of thromboelastogram,and the reference value of coagulation composite index of thromboelastogram in postpartum hemorrhage were tested.The coagulation function,thromboelastogram index were observed.The related factors affecting patients′bleeding were analyzed and risk of each independent factor was performed with multi-factor regression analysis.Results In the pregnancy group,the thromboelastography indexes of the clotting time during the initial clotting phase(R value)and clot formation rate(K value)were lower than those in the non-pregnancy group,with statistically significant differences(P<0.05).The thromboelastography indexes of fibrinogen function(Angle),platelet function(MA value)and comprehensive hemolysis index(CI value)of the pregnancy group were higher than those of the non-pregnancy group,with statistically significant differences(P<0.05).The thromboelastography indexes of R value and K value in the late pregnancy group were lowe

关 键 词：血栓弹力图 凝血综合指标 影响因素 产后出血 

分 类 号：R554.8[医药卫生—血液循环系统疾病]