血栓弹力图对围术期患者输血的临床指导价值(1)
摘 要：目的 探討血栓弹力图(TEG)指导围手术期患者输血的临床应用价值。方法 选取2015年1月～2017年1月择期手术，预计需输血的患者80例，随机分为TEG组和对照组各40例，TEG组患者进行TEG检测和常规凝血项目检测，TEG检测指标主要包括：凝血因子激活时间(R值)、血块形成速率参数(K值)、血栓弹力图最大切角(Angle角)、血栓弹力图最大振幅(MA值)。通过两种方法联合检测进行凝血评估指导输血，对照组按临床常规方法指导输血。手术前后分别采集两组患者的血常规、凝血功能、出血量及输血量等数据并进行比较。结果 TEG组和对照组在年龄、性别、手术类型以及血型分布比较，差异均无统计学意义(P>0.05)；两组患者术前、术后24 h的血红蛋白、血细胞压积、血小板计数、凝血酶原时间、纤维蛋白原比较，差异均无统计学意义(P>0.05)；TEG组TEG各指标(R值、K值、Angle角、MA值)在术前、术中输血前后及术后24 h各时间段比较，差异均有统计学意义(P<0.05)；两组患者术中及术后出血量比较，差异均无统计学意义(P>0.05)；TEG组在输注红细胞、血浆、血小板及输血总量上均明显低于对照组，差异有统计学意义(P<0.05)。结论 应用TEG个体化指导围手术期输血治疗，可减少血液制品使用量，对临床合理用血具有指导意义。
, 百拇医药
关键词：输血；血栓弹力图；围手术期
中图分类号：R457.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.02.027
文章编号：1006-1959(2018)02-0080-04
Abstract：Objective To investigate the clinical value of thrombus elastography(TEG)in guiding perioperative blood transfusion.Methods From January 2015～2017 year in January is expected to elective surgery，80 patients required blood transfusion patients，randomly divided into TEG group and control group with 40 cases in each group，patients in group TEG were detected with TEG and routine coagulation test，TEG detection index mainly includes： factor activation time(R)，blood clot formation rate parameter(K value).Thrombelastogram maximum cutting angle(Angle angle)，the maximum amplitude of Thrombelastogram(MA).The blood clotting was evaluated by two methods，and the blood transfusion was guided by the clinical routine method in the control group.Two groups of patients were collected before and after surgery，blood routine，coagulation function，blood loss and blood transfusion were compared.Results There was no significant difference in age，sex，type of operation and blood group distribution between TEG group and control group(P>0.05).There was no significant difference in hemoglobin，hematocrit，platelet count，prothrombin time and fibrinogen between the two groups before and 24 hours after operation(P>0.05).TEG group TEG indicators(R value，K value，Angle angle，MA value)before and after intraoperative blood transfusion and 24 h after the operation of each time period，The differences were statistically significant(P<0.05)；comparison of two groups of patients with bleeding during and after surgery，there were no significant differences (P>0.05)；group TEG in red blood cell transfusion，plasma，platelet and blood transfusion volume were significantly lower than the control group，the difference was statistically significant(P<0.05).Conclusion The application of TEG guiding individualized perioperative blood transfusion treatment，can reduce the use of blood products，for clinical rational use of blood has guiding significance., 百拇医药(张炳勇 彭红)
, 百拇医药
关键词：输血；血栓弹力图；围手术期
中图分类号：R457.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.02.027
文章编号：1006-1959(2018)02-0080-04
Abstract：Objective To investigate the clinical value of thrombus elastography(TEG)in guiding perioperative blood transfusion.Methods From January 2015～2017 year in January is expected to elective surgery，80 patients required blood transfusion patients，randomly divided into TEG group and control group with 40 cases in each group，patients in group TEG were detected with TEG and routine coagulation test，TEG detection index mainly includes： factor activation time(R)，blood clot formation rate parameter(K value).Thrombelastogram maximum cutting angle(Angle angle)，the maximum amplitude of Thrombelastogram(MA).The blood clotting was evaluated by two methods，and the blood transfusion was guided by the clinical routine method in the control group.Two groups of patients were collected before and after surgery，blood routine，coagulation function，blood loss and blood transfusion were compared.Results There was no significant difference in age，sex，type of operation and blood group distribution between TEG group and control group(P>0.05).There was no significant difference in hemoglobin，hematocrit，platelet count，prothrombin time and fibrinogen between the two groups before and 24 hours after operation(P>0.05).TEG group TEG indicators(R value，K value，Angle angle，MA value)before and after intraoperative blood transfusion and 24 h after the operation of each time period，The differences were statistically significant(P<0.05)；comparison of two groups of patients with bleeding during and after surgery，there were no significant differences (P>0.05)；group TEG in red blood cell transfusion，plasma，platelet and blood transfusion volume were significantly lower than the control group，the difference was statistically significant(P<0.05).Conclusion The application of TEG guiding individualized perioperative blood transfusion treatment，can reduce the use of blood products，for clinical rational use of blood has guiding significance., 百拇医药(张炳勇 彭红)