血栓弹力图监测产科出血性疾病产妇剖宫产围术期凝血功能应用  

The application of thrombus elastic map in monitoring coagulation function during cesarean section of women with obstetrical hemorrhagic diseases

作　　者：冉颜 白华[1] 陈放 RAN Yan;BAI Hua;CHEN Fang(People's Hospital of China Medical University,Shenyang,Liaoning Province,110016)

机构地区：[1]中国医科大学人民医院,沈阳110016

出　　处：《中国计划生育学杂志》2020年第10期1661-1664,共4页Chinese Journal of Family Planning

摘　　要：目的:探析血栓弹力图(TEG)在产科出血性疾病产妇剖宫产围术期凝血功能监测中的应用效果。方法:收集本院2017年4月-2019年3月合并出血性疾病(子痫前期、前置胎盘、妊娠合并肥胖症等)产妇55例临床资料,均为择期剖宫产手术(观察组),正常剖宫产产妇60例为对照组。比较两组产妇术前、术后24h纤维蛋白原(FIB)、凝血酶原时间(PT)、凝血时间(TT)、部分凝血活酶时间(APTT)等指标;TEG监测凝血反应时间(R值)、血凝块形成时间(K值)、凝固角(α角)、最大血凝块强度(MA)及凝血综合指数(CI)。结果:术后24h,两组PT、APTT均低于术前(P<0.05),FIB、TT与术前无差异(P>0.05),PT、TT、APTT、FIB两组间无差异(P>0.05);两组术后24h R值、K值均升高,CI降低(P<0.05),α角、MA与术前比较无差异(P>0.05)。两组术前、术后24h R值、K值、MA比较均无差异(P>0.05),但观察组术前、术后24hα角、CI均低于对照组(P<0.05)。结论:TEG监测出血性疾病产妇剖宫产围术期的凝血功能状态更具优势,可准确评估产妇凝血,并能结合数据分析低凝原因,利于临床早期干预,避免凝血异常而影响产妇预后。Objective: To evaluate the effect of thrombus elastography(TEG)) in monitoring coagulation function during cesarean section of women with obstetrical hemorrhagic diseases. Methods: From April 2017 to March 2019, 55 women with hemorrhagic diseases during pregnancy(preeclampsia, placenta previa, or pregnancy complicated with obesity, etc.) who had undergone optional cesarean section were included in observation group. Another 60 normal women who had undergone cesarean section were selected in control group during the same period. Before and 24 hours after operation, comparison was made between the two groups of the values of four coagulation indexes, such as fibrinogen(FIB), prothrombin time(PT), thrombin time(TT), and partial thrombin time(APTT), TEG monitored blood coagulation reaction time(R value), blood clot formation time(K value), coagulation Angle(Angle), maximum blood clot strength(MA), and blood coagulation composite index(CI). Results: The values of PT and APTT of women in the two groups had decreased significantly 24 hours after operation(P<0.05), but the values of FIB and TT of women in the two groups had no change after operation(P>0.05). There was no significant different in the values of PT, TT, APTT, and FIB of women between the two groups(P>0.05). The R and K values of women in the two groups had increased significantly, but CI value had decreased significantly after operation(P<0.05). The values of α angle and MA had no change after operation(P>0.05). There was no significant difference in the values of R, K and MA of women between the two groups before and 24 hours after operation, but the α angle and CI values of women in the observation group were significant lower than those of women in the control group(P<0.05). Conclusion: TEG has more advantages in monitoring coagulation function during cesarean section of women with hemorrhagic disease, and can accurately evaluate the generalize of coagulation and can analyze the causes of hypocoagulation of women, which is beneficial to early intervent

关 键 词：剖宫产 产科出血性疾病 血栓弹力图 凝血功能 监测 

分 类 号：R714.2[医药卫生—妇产科学]