肝硬化出血患者输血治疗中血栓弹力图的应用价值分析  

Application Value of Thromboelastography in Transfusion Therapy of Cirrhotic Patients with Bleeding Diatheses

作　　者：邹志强[1] 张春明[1] 张永恒 白旭[1] 刘凤芹[1] 杨伯家 ZOUZhiqiang;ZHANG Chunming;ZHANG Yongheng;BAI Xu;LIU Fengqin;YANG Bojia(Zhijiang People’s Hospital,Zhijiang 443200,China)

机构地区：[1]枝江市人民医院,湖北枝江443200

出　　处：《中外医学研究》2022年第19期64-67,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究血栓弹力图用于肝硬化出血患者输血治疗的应用价值。方法:于2020年2月-2022年1月枝江市人民医院收治的肝硬化出血患者中抽取130例进行本次研究,随机数字表法分组,对照组(n=65)在凝血象基础上开展常规输血治疗;研究组(n=65)在对照组基础上应用血栓弹力图指导患者进行输血治疗,比较两组患者凝血功能指标、输血成分治疗量、平均住院时间、住院费用及输血反应发生率。结果:(1)治疗前纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)等凝血功能指标比较,差异无统计学意义(P>0.05),治疗后,研究组FIB水平高于对照组(P<0.05);治疗后,研究组APTT、PT、TT水平均低于对照组(P<0.05)。(2)研究组新鲜冰冻血浆、血小板、冷沉淀治疗量等输血成分均少于对照组(P<0.05)。(3)研究组住院时间(9.37±2.08)d,短于对照组的(10.46±2.11)d,住院费用(5.79±1.14)万元,低于对照组的(6.37±1.17)万元(P<0.05)。(4)研究组输血反应发生率1.54%,低于对照组的10.77%(P<0.05)。结论:应用血栓弹力图对肝硬化出血患者输血治疗指导,可改善凝血功能,减少输血成分,缩短患者平均住院时间,减少患者住院费用,患者输血反应发生率低,可广泛应用。Objective:To investigate the Application value of thromboelastography for transfusion therapy in patients with bleeding cirrhosis.Method:A total of 130 patients with cirrhotic hemorrhage admitted to Zhijiang People’s Hospital from February 2020 to January 2022 were recruited for this study and they were divided into two groups by random number table method.The control group (n=65) was prescribed regular transfusion therapy on the basis of coagulation picture,the study group (n=65) used transfusion treatment guided by thromboelastography on the basis of control group.The coagulation function index,therapeutic volume of transfusion components,mean length of hospital stay,hospital costs,and incidence of transfusion reactions between the two groups were compared.Result:(1) The coagulation function indexes such as fibrinogen (FIB),activated partial thromboplastin time (APTT),prothrombin time (PT) and thrombin time (TT) of before treatment showed no statistically significant differences (P>0.05);the FIB level in the study group was higher than that in the control group after treatment (P<0.05);the levels of APTT,PT,and TT in the study group were lower than those in the control group after treatment (P<0.05).(2) The transfusion components such as fresh frozen plasma,platelets,cryoprecipitate treatment volume in the study group were less than those in the control group after treatment (P<0.05).(3) The hospital stay of the study group was (9.37±2.08) d,shorter than (10.46±2.11) d of the control group,the hospital cost of the study group was (5.79±1.14) ten thousand yuan,which was lower than (6.37±1.17) ten thousand yuan of the control group (P<0.05).(4) The incidence of transfusion reactions in the study group was 1.54%,lower than 10.77% in the control group (P<0.05).Conclusion:The use of thromboelastography for the guidance of transfusion therapy in cirrhotic patients with bleeding may improve coagulation function,reduce the blood transfusion components,shorten the average length of patient hospitalization,reduce t

关 键 词：肝硬化出血 输血治疗 血栓弹力图 

分 类 号：R575.2[医药卫生—消化系统]