TEG体外纠正模型指导下的输血治疗方案选择:一项单中心研究  

Transfusion therapy selection guided by TEG extracorporeal correction model: a single-center study

作　　者：田艳 赖冬 姬长甫 林姝婷 Tian Yan;Lai Dong;Ji Changfu;Lin Shuting(Department of Blood Transfusion,the Second Affiliated Hospital of Xiamen Medical College,Xiamen 361021,China)

机构地区：[1]厦门医学院附属第二医院输血科,厦门361021

出　　处：《血栓与止血学》2023年第1期31-36,共6页Chinese Journal of Thrombosis and Hemostasis

基　　金：厦门市科技计划项目(3502Z20194060)。

摘　　要：目的 探讨血栓弹力图(TEG)体外实验引导下的个体化输血方案在创伤性凝血病(TIC)患者凝血纠正中的重要意义。方法 回顾性分析自2013年7月到2021年7月来我院就诊TIC患者121例,以TEG体外实验指导下用血的患者52例为体外实验组,临床输血指南指导下用血的患者69例为非体外实验组。分析体外实验组和非体外实验组的7 d存活率、12 h凝血纠正率、ICU住院天数和住院死亡率。结果 在输注选择方面,体外实验组先输注冷沉淀的患者数目显著高于非体外实验组(P<0.05)。在临床评价方面,与非体外实验组相比,体外实验组,12 h凝血纠正率、7 d存活率、冷沉淀的输注量均显著增高(P<0.05),而ICU住院天数、住院死亡率、血浆和红细胞的输注量以及总用血量均显著下降(P<0.05)。结论 TEG体外实验指导下的临床输血方案能为患者提供个体化针对性输注,为急诊抢救TIC提供最佳凝血纠正方案的同时也节约了血液资源,为构建规范化危重症凝血紊乱的纠正模型提供理论依据。Objective To investigate the significance of individualized blood transfusion regimen guided by thrombelastogram( TEG) in vitro in the correction of coagulation in patients with traumainduced coagulopathy( TIC).Methods A total of 121 patients with severe coagulation disorder after severe trauma who was treated in our hospital from July 2013 to July 2021 were retrospectively analyzed.Among them, 52 patients blood under the guidance of TEG in vitro experiment were selected as in vitro experimental group, and 69 patients blood under the guidance of clinical blood transfusion guidelines were selected as non-in vitro experimental group. The 7-day survival rate, 12-hour coagulation correction rate,the length of stay in the ICU and in-hospital mortality rate of in vitro and non-in vitro groups were analyzed.Results In terms of infusion sequence, the number of patients receiving cryoprecipitate first in vitro experimental group was significantly higher than that of non-in vitro experimental group(P< 0. 05). In clinical evaluation, compared with the non-in vitro experimental group, the 12-hour coagulation correction rate, 7-day survival rate and the amount of cryoprecipitate infusion were significantly higher in vitro experimental group(P<0.05), while length of stay in the ICU, the in-hospital mortality rate, the amount of plasma and red blood cell infusion, and the total blood consumption were significantly decreased(P<0.05).Conclusion The clinical transfusion protocol guided by TEG in vitro experiment can provide individualized infusion for patients, provide the best coagulation correction protocol for TIC emergency rescue and save blood resources, and provide theoretical basis for the establishment of standardized correction model of critical coagulation disorder.

关 键 词：血栓弹力图 创伤性凝血病 凝血紊乱 输血方案 体外实验 

分 类 号：R457.1[医药卫生—治疗学]