血栓弹力图在创伤大出血伴严重凝血功能障碍患者输血指导中的应用效果  

Application effect of thromboela-stogram in blood transfusion guidance for patients with traumatic massive hemorrhage and severe coagulation disorder

作　　者：李茜 吴新明 樊继泷[2] 张林海 霍霓 LI Qian;WU Xinming;FAN Jilong;ZHANG Linhai;HUO Ni(Department of Blood Transfusion,Lianyungang Second People’s Hospital,Jiangsu Province,Lianyungang222000,China;Department of Hepatobiliary Surgery,Lianyungang Second People’s Hospital,Jiangsu Province,Lianyungang222000,China)

机构地区：[1]江苏省连云港市第二人民医院输血科,江苏连云港222000 [2]江苏省连云港市第二人民医院肝胆外科,江苏连云港222000

出　　处：《中国医药导报》2023年第31期106-109,共4页China Medical Herald

基　　金：江苏省自然科学基金面上项目(BK20201154)。

摘　　要：目的探讨创伤大出血伴严重凝血功能障碍患者血栓弹力图指导输血的应用。方法选取2018年12月至2021年12月江苏省连云港市第二人民医院接诊的107例创伤大出血伴严重凝血功能障碍患者,采用随机数字表法分为常规组(54例,常规凝血功能检测)和研究组(53例,血栓弹力图检测)。统计输血前后活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)和纤维蛋白原(FIB)。统计输血过程中血小板、血浆、红悬液、冷沉淀的用量。统计住院时间与ICU治疗时间和住院期间并发症的发生情况。结果输血后,两组APTT、PT、TT短于输血前,且研究组短于常规组;两组FIB高于输血前,且研究组高于常规组,差异有统计学意义(P<0.05)。研究组血小板、血浆、红悬液、冷沉淀的用量少于常规组,差异有统计学意义(P<0.05)。两组住院时间比较,差异无统计学意义(P>0.05)。研究组ICU入住时间短于常规组,差异有统计学意义(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论血栓弹力图检查在指导创伤大出血伴严重凝血功能障碍患者输血中具有一定指导价值。Objective To investigate the application of thromboela-stogram to guide blood transfusion in patients with traumatic massive hemorrhage and severe coagulation disorder.Methods A total of 107 patients with traumatic massive hemorrhage with severe coagulation disorder were selected from Lianyungang Second People’s Hospital of Lianyungang City,Jiangsu Province from December 2018 to December 2021,and were divided into routine group(54 cases with routine coagulation function detection)and study group(53 cases with thromboela-stogram detection)by random number table method.Activated partial thrombin time(APTT),prothrombin time(PT),thrombin time(TT),and fibrinogen(FIB)were measured before and after blood transfusion.The amounts of platelets,plasma,red suspension,and cryoprecipitate were counted during blood transfusion.The duration of hospitalization and ICU treatment and the incidence of complications during hospitalization were analyzed.Results After transfusion,APTT,PT,and TT in two groups were shorter than those before transfusion,while those in the study group were lower than those in the routine group;FIB was higher than that before transfusion,while that in the study group was higher than that in the routine group,and the differences were statistically significant(P<0.05).The dosage of platelet,plasma,red suspension,and cryoprecipitate in the study group were lower those that in the routine group,and the differences were statistically significant(P<0.05).There was no significant difference in hospital stay between the two groups(P>0.05).The duration of ICU stay in the study group was shorter than that in the routine group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Thromboelastogram examination has a certain guiding value in guiding blood transfusion in patients with traumatic hemorrhage and severe coagulation disorder.

关 键 词：创伤大出血 凝血功能障碍 血栓弹力图 输血 指导应用 

分 类 号：R619[医药卫生—外科学]