血栓弹力图在创伤性术后凝血功能异常患者围术期输血指导中的应用  

Application of Thromboelastography in Perioperative Blood Transfusion Guidance of Patients with Traumatic Postoperative Coagulation Dysfunction

作　　者：贲燕华[1] 夏和凤[1] 于泽芝 BEN Yanhua;XIA Hefeng;YU Zezhi(Blood Transfusion Department,Dongtai City People's Hospital,Dongtai,Jiangsu,224200)

机构地区：[1]东台市人民医院输血科,江苏东台224200

出　　处：《智慧健康》2023年第12期95-98,共4页Smart Healthcare

摘　　要：目的 探讨创伤性术后凝血功能异常患者围术期临床输血指导中血栓弹力图(TEG)的应用价值。方法 回顾性分析本院2020年6月-2022年6月收治的89例创伤性术后凝血功能异常患者资料,行血液制品输注前及输注后24h常规凝血四项功能检测的为凝血组(n=44),依据TEG检测数据指导临床血液成分输血的为TEG组(n=45)。分析两组凝血状况,输血前后TEG组TEG指标、凝血反应时间(R)、血凝块形成时间(K)、最大振幅(MA)、总体凝血指数(CI)、α角,血液应用情况(FFP、CRYO、PLT、CRCs)。结果 输血前,两组凝血指标对比(P>0.05);输血后,两组PT、APTT、TT、FIB较输血前均明显改善,且与凝血组比较,TEG组PT、APTT、TT更短,FIB水平更高(P<0.05);与输血前比较,输血后患者R、K值更低,MA、CI、α角更大(P<0.05);与凝血组比较,TEG组血液制品FFP、CRYO、PLT、CRCs使用量均明显更少(P<0.05)。结论 TEG指导下进行创伤性术后凝血功能异常患者围术期输血,可有效改善患者凝血功能及TEG指标,有助于临床科学合理用血。Objective To explore application value of thromboelastography(TEG)in perioperative clinical blood transfusion guidance of patients with traumatic postoperative coagulation dysfunction.Methods The paper reviewed and analyzed data of 89 patients with postoperative coagulation dysfunction admitted to our hospital from June 2020 to June 2022.Coagulation group(n=44)was treated with routine coagulation tests before and 24 hours after blood product infusion,TEG group(n=45)with clinical blood component transfusion guided by TEG test data.Coagulation status between two groups was analyzed,including TEG indicators,coagulation reaction time(R),clot formation time(K),maximum amplitude(MA)and overall coagulation index(CI),αangle before and after blood transfusion,blood application status(FFP,CRYO,PLT,CRCs).Results Before blood transfusion,coagulation indicators comparison between two groups showed P>0.05.After blood transfusion,the PT,APTT,TT and FIB levels in both groups were significantly better than before transfusion,TEG group had shorter PT,APTT,TT and higher FIB levels than coagulation group,(P<0.05).The R and K values after blood transfusion were lower than before blood transfusion,while MA,CIαangle was larger,(P<0.05).Blood products FFP,CRYO,PLT and CRCs in TEG group was significantly lower than coagulation group,(P<0.05).Conclusion Under guidance of TEG,perioperative blood transfusion can improve coagulation function and TEG indicators of patients with traumatic postoperative coagulation dysfunction effectively,and contribute to scientific and rational use of blood in clinical practice.

关 键 词：创伤 凝血功能异常 围术期输血指导 血栓弹力图 

分 类 号：R641[医药卫生—外科学] R457.1[医药卫生—临床医学]