多发性创伤患者TEG检查与传统凝血功能检查的相关性分析  

Correlation Analysis between TEG Test and Conventional Coagulation Test in Patients with Multiple Trauma

作　　者：许祖林 侯昌权 易彩响 曾宪江 XU Zulin;HOU Changquan;YI Caixiang;ZENG Xianjiang(Xinjian Hospital of Yichun City,Jiangxi Province,Yichun 336000,China)

机构地区：[1]江西省宜春新建医院,江西宜春336000

出　　处：《中国医学创新》2023年第13期144-148,共5页Medical Innovation of China

基　　金：江西省宜春市指导性科技计划项目(2022ZDJH6154)。

摘　　要：目的:分析多发性创伤患者血栓弹力图(TEG)检查与传统凝血功能检查(CCT)的相关性。方法:回顾性选取宜春新建医院2020年3月-2022年8月收治的97例多发性创伤患者,均进行CCT检查,检查内容包括凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)和D-二聚体(D-D)。另外采用TEG检查评价患者凝血功能,检查内容包括凝固反应时间(R值)、水平夹角(Angle角)、凝血速率(K值)及最大振幅(MA值)。比较两种检查方法的相关性,并对二者的临床价值进行分析评价。结果:CCT结果显示,与伤后6 h比较,伤后12 h时的PT、APTT均有延长(P<0.05)。伤后6、12 h的TT比较,差异有统计学意义(P<0.05)。与伤后6 h比较,伤后12 h时的FIB、D-D水平均降低(P<0.05)。TEG结果显示,与伤后6 h比较,伤后12 h时的R值、K值和Angle角均增大,MA值减小(P<0.05)。R值与PT、APTT均呈正相关,与FIB呈负相关(P<0.001)。K值与TT呈负相关,Angle角与TT呈负相关(P<0.001)。K值与FIB呈负相关,Angle角与FIB呈负相关(P<0.001)。TEG检出低凝状态40例,阳性率41.24%(40/97),CCT检出阳性31例,阳性率31.96%(31/97),差异有统计学意义(χ2=4.923,P<0.05),一致性中等(Kappa=0.714)。结论:TEG检查多发性创伤患者的凝血功能,部分指标与CCT结果有显著相关性。临床上宜将两种检查方法联合使用,通过综合结果判断,以完成更精准的多发性创伤患者出血风险检测。Objective:To analyze the correlation between thromboelastography(TEG)test and conventional coagulation text(CCT)examination in patients with multiple trauma.Method:A total of 97 patients with multiple trauma who were treated in Xinjian Hospital of Yichun City from March 2020 to August 2022 were retrospectively selected,and all of them underwent CCT examination,the examination contents include prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)and D-dimer(D-D).In addition,TEG examination was used to evaluate the coagulation function of patients.The inspection contents included coagulation reaction time(R value),horizontal angle(Angle angle),coagulation rate(K value)and maximum amplitude(MA value).The correlation between the two methods and evaluate their clinical value were compared.Result:CCT results showed that,compared with 6 h after injury,PT and APTT at 12 h after injury were prolonged(P<0.05).The TT at 6 and 12 h after injury was compared,there was significant difference(P<0.05).Compared with 6 h after injury,FIB and D-D levels were decreased at 12 h after injury(P<0.05).TEG results showed that,compared with 6 h after injury,R value,K value and Angle increased at 12 h after injury,while MA value decreased(P<0.05).R value was positively correlated with PT and APTT,but negatively correlated with FIB(P<0.001).K value was negatively correlated with TT,and Angle was negatively correlated with TT(P<0.001).K was negatively correlated with FIB,and Angle was negatively correlated with FIB(P<0.001).The positive rate was 41.24%(40/97)in 40 cases of low coagulation by TEG test and 31.96%(31/97)in 31 cases of CCT,the difference was statistically significant(P<0.05),medium consistency(Kappa=0.714).Conclusion:The coagulation function of patients with multiple trauma was examined by TEG,and some indicators were significantly correlated with the results of CCT.Clinically,it is advisable to combine the two inspection methods and judge the comprehensive results to complete a more

关 键 词：多发性创伤 TEG 检查 传统凝血功能检查 

分 类 号：R641[医药卫生—外科学] R446.1[医药卫生—临床医学]