血栓弹力图指导食管癌患者临床输血的价值及其与常规凝血实验检测指标的相关性分析  

The Value of Thromboelastography in Guiding the Clinical Blood Transfusion of Esophageal Cancer Patients and the Correlation between Thromboelastography and Routine Blood Coagulation Test

作　　者：马瑞东[1] 曾小飞[1] 陆宇海 王洪 何小平[1] 张洋航 MA Rui-dong;ZENG Xiao-fei;LU Yu-hai;WANG Hong;HE Xiao-ping;ZHANG Yang-hang(Department of Cardiothoracic Surgery,The First Affiliated Hospital of Chengdu Medical College,Chengdu,Sichuan,610500,China)

机构地区：[1]成都医学院第一附属医院胸心外科,四川成都610500

出　　处：《现代生物医学进展》2021年第3期549-552,566,共5页Progress in Modern Biomedicine

基　　金：四川省教育厅科研基金项目(18ZA0165)。

摘　　要：目的:探讨血栓弹力图(TEG)指导食管癌患者临床输血的价值及其与常规凝血实验检测指标的相关性。方法:选取2017年1月-2019年3月在我院收治的食管癌手术治疗需输血的99例患者作为研究对象,将99例患者随机分为常规凝血功能检测组和TEG组,常规凝血功能检测组采用常规凝血实验检查结果指导输血,TEG组采用TEG检查结果指导输血,对比两组输血前后的常规凝血实验检测指标以及临床用血量,对比TEG组输血前后的TEG指标,分析TEG指标与常规凝血实验检测指标的相关性。结果:两组患者输血前凝血四项和血小板计数(PLT)差异无统计学意义(P>0.05),输血后两组活化凝血酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)均有不同程度的改善(P<0.05),TEG组PT、TT较常规凝血功能检测组低(P<0.05);输血后,TEG组患者凝血反应时间(R值)、血凝块形成时间(K值)较输血前降低,最大血凝块强度(MA值)、凝血综合指数(CI值)升高,凝血形成速率(Angle角)增大,差异有统计学意义(P<0.05);Pearson相关性分析结果显示,R值与APTT呈正相关(P<0.05),K值与PLT呈负相关,与FIB呈正相关(P<0.05),Angle角、MA值、CI值与FIB、PLT呈正相关(P<0.05);TEG组新鲜冰冻血浆、冷沉淀输注量少于常规凝血功能检测组,差异有统计学意义(P<0.05)。结论:TEG能更好地指导食管癌手术患者各种血液成分的合理输注,有效改善凝血异常情况,减少输血用量,TEG指标与常规凝血实验检测指标存在一定的相关性。Objective: To explore the value of thromboelastography(TEG) in guiding clinical blood transfusion in patients with esophageal cancer and its correlation with routine blood coagulation test. Methods: 99 patients who needed blood transfusion for surgical treatment of esophageal cancer who were admitted to our hospital from January 2017 to March 2019 were selected as subjects. 99 patients were randomly divided into the conventional coagulation function test group and the TEG group. The conventional coagulation function test group used the results of conventional coagulation tests to guide blood transfusion, and the TEG group used the results of TEG tests to guide blood transfusion. The conventional coagulation test indicators and clinical blood volume before and after blood transfusion in the two groups were compared. TEG indexes before and after blood transfusion in TEG group were compared. The correlation between TEG and routine coagulation test was analyzed. Results: There was no significant difference in coagulation four and platelet counts(PLT) between the two groups(P>0.05). After blood infusion,the thrombin time(APTT), prothrombin time(PT), and thrombin time(TT), Fibrinogen(FIB) were improved in different degrees(P<0.05). The PT and TT in the TEG group were lower than those in the conventional coagulation function test group(P<0.05). After blood transfusion, the coagulation reaction time(R value) and blood clot formation time(K value) in TEG group were lower than those before blood transfusion, the maximum clot intensity(MA value) and the comprehensive clotting index(CI value) were increased, the coagulation formation rate(Angle) were increased, and the differences were statistically significant(P<0.05). Pearson correlation analysis showed that R value was positively correlated with APTT(P<0.05). K value was negatively correlated with PLT, and positively correlated with FIB(P<0.05), while Angle Angle, MA value and CI value were positively correlated with FIB and PLT(P<0.05). The amount of fresh frozen plasma

关 键 词：血栓弹力图 常规凝血功能检测 食管癌 临床输血 

分 类 号：R735.1[医药卫生—肿瘤]