摘要
目的探讨血栓弹力图(TEG)在产后出血患者凝血功能监测及其指导临床输血中的应用价值。方法对100例行剖宫产术分娩的产后出血患者按输血指导方式的不同分为观察组和对照组,每组50例。对2组患者均行TEG[在产后1 h内检测TEG,检测指标包括凝血因子反应时间(TEG-R)、纤维蛋白原反应时间(TEG-K)、凝固角(TEG-α角)、最大振幅(TEG-MA)]和常规凝血功能检测[在产后1 h内检测血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、国际标准化比值(INR)和纤维蛋白原(FIB)的水平],监测凝血功能。观察组以TEG检测结果指导输血,对照组以常规凝血功能检测结果指导输血。结果 TEG检测低凝阳性率明显高于常规凝血检测,差异有统计学意义(57.0%比26.0%,P<0.05);观察组血浆、红细胞、冷沉淀、血小板输注量均少于对照组,差异有统计学意义(P<0.05)。结论 TEG在产后出血患者凝血功能监测及临床输血指导中效果优于常规凝血功能检查。
Objective To explore the value of thromboelastography(TEG) in monitoring coagulation function and guiding clinical blood transfusion in patients with postpartum hemorrhage. Methods One hundred patients with postpartum hemorrhage after cesarean section were divided into two groups,with 50 patients in each group.The TEG was detected in both groups within 1 hour after delivery,including coagulation factor response time(TEG-R),fibrinogen reaction time(TEG-K),coagulation angle(TEG-alpha angle),maximum amplitude(TEG-MA).Plasma prothrombin time(PT),activated partial thromboplastin time(APTT) and thrombin time(TT),international standardized ratio(INR) and fibrinogen(FIB) levels were measured within 1 hour after delivery to monitor coagulation function.In addition,blood transfusion was guided by either TEG test results(observation group) or routine coagulation function test results(control group). Results TEG test achieved a higher low-pour-point positive rate than routine coagulation test(57.0% vs 26.0%, P <0.05).Furthermore,the amounts of plasma,erythrocyte,cryoprecipitate and platelet transfusion in observation group were less than those in control group( P <0.05). Conclusion TEG is superior to routine coagulation function test in monitoring coagulation function and guiding clinical blood transfusion in patients with postpartum hemorrhage.
作者
吴珊
刘淮
WU Shan;LIU Huai(2012 Grade of Medical Department of Graduated School,Nanchang University;Department of Obstetrics,Jiangxi Provincial Maternal and Child Health Hospital,Nanchang 330006,China)
出处
《实用临床医学（江西）》
CAS
2019年第1期40-42,共3页
Practical Clinical Medicine
关键词
产后出血
血栓弹力图
凝血功能
输血
postpartum hemorrhage
thromboelastography
coagulation function
blood transfusion
