血栓弹力图监测止凝血功能在择期骨科手术患者输血中的效果  

Effect of thrombelastogram in monitoring hemostatic and coagulation function in patients undergoing elective orthopedic surgery during blood transfusion

作　　者：刘玮[1] 张乃莹 LIU Wei;ZHANG Naiying(Department of Blood Transfusion,Honghui Hospital Affiliated to Xi’an Jiaotong University,,Xi'an,Shanxi,710054;Department of Laboratory Medicine,Xi’an City Central Hospital Affiliated to Xi’an Jiaotong University,Xi'an,Shanxi,710001)

机构地区：[1]西安交通大学附属红会医院输血科,陕西西安710054 [2]西安交通大学附属西安市中心医院检验科,陕西西安710001

出　　处：《实用临床医药杂志》2020年第20期11-14,共4页Journal of Clinical Medicine in Practice

基　　金：陕西省卫生和计划委员会科研项目(S2016TFSF0370)。

摘　　要：目的探讨血栓弹力图(TEG)监测止凝血功能在择期骨科手术患者输血中的效果。方法将300例择期骨科手术患者根据摸球分组法分为2组。对照组(n=150)采用常规凝血指标指导输血,研究组(n=150)采用TEG监测止凝血功能指导输血。比较2组治疗效果。结果术后,研究组凝血酶原时间(PT)、活化部分凝血活酶时间短于对照组,纤维蛋白原(FIB)高于对照组,差异有统计学意义(P<0.05);研究组术中出血量、术后24 h出血量及新鲜冰冻血浆、悬浮红细胞、血红蛋白、血小板用量少于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率为1.33%,低于对照组的8.67%,差异有统计学意义(P<0.05)。结论择期骨科手术中实施TEG监测止凝血功能指导输血可维持凝血功能稳定,控制出血量和血液制品用量,减少输血后不良反应的发生。Objective To investigate the effect of thrombelastogram(TEG)in monitoring hemostatic and coagulation function in patients undergoing elective orthopedic surgery during blood transfusion.Methods A total of 300 elective orthopedic surgery patients were divided into two groups by ball touching grouping method.Control group(n=150)received blood transfusion guided by conventional coagulation indicators,while the research group(n=150)received blood transfusion guided by TEG in monitoring of hemostatic and coagulation function.The therapeutic effects of the two groups were compared.Results After surgery,prothrombin time(PT)and activated partial thrombin time in the research group were significantly shorter,and FIB was significantly higher than those in the control group(P<0.05);the amount of intraoperative blood loss,postoperative 24 h blood loss,and the amount of fresh frozen plasma,suspended red blood cells,hemoglobin and platelets in the research group were significantly less than those in the control group(P<0.05);the incidence of adverse reactions was 1.33%in the research group,which was significantly lower than 8.67%in the control group(P<0.05).Conclusion During elective orthopedic surgery,the implementation of TEG in monitoring hemostatic and coagulation function in guiding blood transfusion can maintain stability of coagulation function,control the amount of blood loss and the amount of blood products,and reduce the occurrence of adverse reactions after blood transfusion.

关 键 词：择期骨科手术 血栓弹力图 止凝血功能 输血 

分 类 号：R687.3[医药卫生—骨科学] R457.1[医药卫生—外科学]