急重型颅脑损伤凝血功能障碍患者围手术期血栓弹力图监测的临床意义  

Clinical Significance of Perioperative Thromboelastography Monitoring in Patients with Coagulation Dysfunction after Acute Severe Craniocerebral Injury

作　　者：潘锡红 陈丽华 赖鹏飞 谢地发 Pan Xihong(Yudu people's Hospital of Jiangxi Province,Ganzhou Jiangxi 342300)

机构地区：[1]江西省于都县人民医院,江西赣州342300

出　　处：《黑龙江医药》2021年第5期1015-1018,共4页Heilongjiang Medicine journal

基　　金：赣州市卫生健康委员会市级科研计划项目(编号:2020-2-140)。

摘　　要：目的:观察急重型颅脑损伤凝血功能障碍患者围手术期血栓弹力图监测的临床意义分析。方法:将在我院(2019年8月至2021年1月时期)入住我院神经外科ICU的重型颅脑损伤,围手术期血栓弹力图相关参数异常诊断为凝血功能障碍患者30例,在TEG相关参数指导下对凝血功能障碍进行纠正为试验组。而选取既往收治重型颅脑损伤根据围手术期常规凝血指标检测为凝血功能障碍患者30例为对照组。数据收集完成后,明确两种监测指导手段对患者治疗的有效性,诊断的敏感性及特异性,统计再出血率、围手术期输血量、死亡率。结果:试验组患者的诊断有效性、敏感性与特异性均高于对照组,差异(P<0.05)有意义。实验组患者再出血率、死亡率均低于对照组,而围手术期输血量少于对照组,差异(P<0.05)有意义。结论:根据血栓弹力图动态监测相关参数提示指导下对凝血功能障碍进行纠正,能减少患者再出血率、围手术期输血量、抗凝药物使用时机、减少死亡率,效果理想。故血栓弹力图的临床指导意义较大,具有一定的推广价值。Objective:To observe the clinical significance of perioperative thromboelastography monitoring in patients with coagulation dysfunction after acute and severe craniocerebral injury.Methods:30 patients with severe craniocerebral injury admitted to Neurosurgery ICU of our hospital from August 2019 to January 2021 were diagnosed as coagulation dysfunction by abnormal parameters of thromboelastography during perioperative period,and the coagulation dysfunction was corrected under the guidance of TEG parameters as the experimental group.30 patients with coagulation dysfunction were selected as the control group.After data collection,the efficacy,sensitivity and specificity of the two monitoring methods for the treatment of patients were clarified,and the incidence of rebleeding,rebleeding rate and mortality were counted.Results:The diagnostic effectiveness,sensitivity and specificity of the experimental group were higher than those of the control group(P<0.05).The rebleeding rate and mortality in the experimental group were lower than those in the control group,while the amount of perioperative blood transfusion was less than that in the control group(P<0.05).Conclusion:According to the relevant parameters of dynamic monitoring of thromboelastography,the correction of coagulation dysfunction can reduce the incidence of rebleeding,rebleeding rate,the use of anticoagulant drugs,and reduce mortality.Therefore,thromboelastography has great clinical significance,and has a certain promotion value.

关 键 词：急重型 颅脑损伤 凝血功能障碍 围手术期 血栓弹力图 监测指导治疗 

分 类 号：R651.15[医药卫生—外科学]