血栓弹力图在妊娠合并血小板减少患者中的应用  

Application of thrombelastography in pregnancy with thrombocytopenia

作　　者：闫慧[1] 杨子怡[1] 谢静静 蒋姝婷[1] 燕备战[1] YAN Hui;YANG Zi-yi;XIE Jing-jing;JIANG Shu-ting;YAN Bei-zhan(Henan Provincial People's Hospital,Zhengzhou 45000,China)

机构地区：[1]河南省人民医院输血科,郑州450000

出　　处：《医药论坛杂志》2022年第18期56-58,共3页Journal of Medical Forum

摘　　要：目的 探讨血栓弹力图在妊娠合并血小板减少患者中的应用。方法 收集2021年1月—2022年1月河南省人民医院收治的29例妊娠合并血小板减少症患者做观察组,30例同期于我院分娩的健康孕妇为对照。依据血小板计数(PLT)80×10^(9)/L、50×10^(9)/L为临界点,将观察组分为3组:A组(80^(9)9)×10^(9)/L组,B组(50~79)×10^(9)/L组,C组<50×10^(9)/L组。比较观察组和对照组血栓弹力图参数,产时出血情况,分析MA值与PLT和产时出血量的相关性。结果 观察组A组,B组血栓弹力图各参数和产时出血量与对照组均无显著差异(P>0.05),C组R值、K值大于对照组,а角、MA值及CI值小于对照组,差异有统计学意义(P<0.05),产时出血量高于对照组(P<0.05)。A组与C组、B组与C组产时出血量均无显著差异。对照组、A组、B组产时及产后输注红细胞和血小板量均小于C组,差异有统计学意义(P<0.05)。MA值与孕妇PLT相关性为显著相关,与产时出血量弱负相关。结论 血栓弹力图可以作为监测妊娠合并血小板减少患者凝血水平的指标,一定程度上可预测其产时出血量。Objective To analyze the application of thrombelastography(TEG) in pregnancy with thrombocytopenia.Methods Totally 29 pregnant patients with thrombocytopenia from January 2021 to January 2022 were collected as the observation group, and 30 healthy pregnant women who gave birth in our hospital during the same period were selected as the control group.According to platelet count(PLT) 80×10^(9)/L and 50×10^(9)/L as critical points, the observation group was divided into 3 groups: group A(80-99)×10^(9)/L, group B(50-79)×10^(9)/L, C group <50×10^(9)/L.The thromboelastography parameters and bleeding during childbirth were compared between the observation group and the control group, and the correlation between MA value and PLT and intrapartum hemorrhage was analyzed.Results There was no significant difference in the parameters of thromboelastography and intrapartum hemorrhage in the observation group A and group B compared with the control group(P>0.05).The R value and K value of the C group were higher than those of the control group, and the α angle, MA value and CI value were lower than those of the control group, and the differences were statistically significant(P<0.05).Intrapartum hemorrhage in group C was higher than that in control group(P<0.05).The amount of red blood cells and platelets transfused during and after delivery in the control group, group A, and group B were lower than those in group C, and the difference was statistically significant(P<0.05).MA value was significantly correlated with maternal PLT, and weakly negatively correlated with intrapartum hemorrhage.Conclusion Thromboelastography can be used as an indicator for monitoring the blood coagulation level in pregnant patients with thrombocytopenia, and can predict the amount of intrapartum hemorrhage to a certain extent.

关 键 词：血栓弹力图 妊娠合并血小板减少 产时出血 

分 类 号：R714.254[医药卫生—妇产科学]