血栓弹力图在溶栓治疗中的临床应用价值分析  

Clinical application of thrombus elastography in thrombolytic therapy

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作  者:周波[1] 杨志[1] 秦冬梅[1] 何昭[1] 王娟[1] 敬官明 ZHOU Bo;YANG Zhi;QIN Dongmei;HE Zhao;WANG Juan;JING Guanming(Clinical Laboratory,Daying County People’s Hospital,Suining,Sichuan 629300,China)

机构地区:[1]大英县人民医院检验科,四川遂宁629300

出  处:《医药前沿》2021年第26期15-17,共3页Journal of Frontiers of Medicine

摘  要:目的:分析血栓弹力图在溶栓治疗中的应用价值。方法:选择我院2019年7月—2020年7月间收治的70例急性脑梗死患者,患者入院时采用阿替普酶进行静脉溶栓干预,获取治疗前后的血液标本,进行血栓弹力图检测,选择C T脑灌注成像(C T P)对病灶侧和病灶对侧进行检查。结果:治疗3 h后,25例R值<5,在溶栓基础上选择舒洛地特进行抗凝处理,13例MA值>70,使用阿司匹林联合氯吡格雷干预,治疗6 h后,血栓弹力图显示22例患者R值恢复平稳,3例MA值恢复正常,经过CTP检查后发现,病灶侧的局部脑血容量(rCBV)、局部脑血流量(rCBF)、达峰时间较之病灶对侧差异显著(P<0.05)。结论:在溶栓治疗中应用血栓弹力图,能及时掌控患者的凝血情况,辅助医师决定是否需要使用抗凝、抗血小板药物,对患者的治疗具有积极影响,同时CTP的使用,能够确定患者是否需要进行溶栓治疗。Objective To study the effect of thromboelastography in thrombolytic therapy.Methods 70 patients with acute cerebral infarction admitted to our hospital from July 2019 to July 2020 were selected as the research objects.The patients were treated with alteplase for intravenous thrombolysis when they were admitted to the hospital,and blood samples before and after treatment were obtained for thromboela-stogram detection,CT cerebral perfusion imaging(CTP)is selected to examine the side of the lesion and the opposite side of the lesion.Results After 3 hours of treatment,25 cases of R value<5,sulodexide was selected for anticoagulation treatment on the basis of thrombolysis,13 cases of MA value>70,treated with aspirin combined with clopidogrel intervention,after 6 hours of treatment,thromboelastogram It showed that the R value of 22 patients returned to a stable level,and the MA value of 3 patients returned to normal.After CTP examination,it was found that the regional cerebral bloodflow(rCBF),regional cerebral blood volume(rCBV)and peak time on the side of the lesion were different from those on the other side of the lesion.Significantly(P<0.05).Conclusion The application of thromboelastography in thrombolytic therapy can control the patient’s coagulation situation in time,and assist the physician in deciding whether to use.Anticoagulant and antiplatelet drugs have a positive impact on the patient’s treatment.At the same time,the use of CTP can determine the patient to need thrombolytic therapy or not.

关 键 词:血栓弹力图 溶栓治疗 临床效果 

分 类 号:R743.3[医药卫生—神经病学与精神病学]

 

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