探讨血清同型半胱氨酸联合血栓弹力图(TEG)评估急性创伤患者凝血功能障碍的临床价值  

To Explore the Clinical Value of Serum Homocysteine Ccombined with Thromboelastography(TEG)in Assessing Coagulation Dysfunction in Patients with Acute Trauma

作　　者：肖丰[1] 陈松[2] 宋岩[1] 于慧超[1] 马玉东[1] 胡紫薇[3] 张晓娟[3] XIAO Feng;CHEN Song;SONG Yan;YU Huichao;MA Yudong;HU Ziwei;ZHANG Xiaojuan(Department of ICU,Affiliated Central Hospital of Shenyang Medical College,Shenyang 110024,China;Department of Emergency,the First Affiliated Hospital of Hainan Medical College,Haikou 570102,China;Department of ICU,the First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]沈阳医学院附属中心医院ICU,辽宁沈阳110024 [2]海南医学院第一附属医院急诊,海南海口570102 [3]中国医科大学附属第一医院ICU,辽宁沈阳110001

出　　处：《中国医药指南》2021年第24期71-73,共3页Guide of China Medicine

摘　　要：目的探讨血清同型半胱氨酸联合血栓弹力图(TEG)评估急性创伤患者凝血功能障碍的临床价值。方法择取2017年3月至2020年3月规划研究时区,并就该时区中抽取出本院收治的89例严重创伤患者设为本研究样本对象。依据是否具凝血功能障碍予以分组。对照组对象无凝血功能障碍(44例);观察组对象具凝血功能障碍(45例)。分析比对两组对象血栓弹力图、Hcy水平以及凝血功能指标。结果观察组凝血反应时间、凝血块形成时间均大幅度高于对照组,而凝固角、血栓最大振幅则明显低于对照组,各项比对结果均差异显著(P<0.001);观察组对象纤维蛋白原显著低于对照组,而血清同型半胱氨酸、血浆凝血酶原时间、活化部分凝血酶时间以及凝血活酶时间均显著高于对照组,各项比对结果均差异显著(P<0.001)。结论采用血清同型半胱氨酸联合血栓弹力图评估急性创伤患者凝血功能障碍方面具有显著效果,能密切监测患者的凝血机制,具有较高的临床应用价值。Objective To explore the clinical value of serum homocysteine combined with thromboelastography(TEG)in assessing coagulation dysfunction in patients with acute trauma.Methods Select the planned study time zone from March 2017 to March 2020,and select 89 severe trauma patients admitted to this hospital from this time zone as the sample objects of this study.Groups are based on whether they have coagulation dysfunction.The control group had no coagulation dysfunction(44 cases);the observation group had coagulation dysfunction(45 cases).Analyze and compare the thromboelastogram,Hcy level and coagulation function indexes of the two groups.Results The reaction time and clot formation time of the observation group were significantly higher than those of the control group,while theα-Angle and maximum amplitude were significantly lower than those of the control group,the comparison results were significantly different(P<0.001);and the fibrinogen of observation group was significantly lower than that of the control group,while the serum homocysteine,plasma prothrombin time,activated partial thrombin time,and thromboplastin time were significantly higher than those of the control group,and the comparison results were different significant(P<0.001).Conclusion The use of serum homocysteine combined with thromboelastography to assess coagulation dysfunction in patients with acute trauma has a significant effect,can closely monitor the coagulation mechanism of replacement,and has high clinical application value.

关 键 词：急性创伤 凝血功能障碍 血清同型半胱氨酸 血栓弹力图 

分 类 号：R641[医药卫生—外科学]