中文摘要：

目的 探讨血栓弹力图（thromboelastography,TEG）与凝血试验各项指标的相关性,评价两种方法在指导心脏手术患者围术期输血中的意义。方法 分析本院2014年9月—2016年8月收治的108位心脏手术患者,随机分为TEG检测指导输血组（实验组）和凝血试验指导输血组（对照组）,分别就两组的输血率、不同成分血的输血量及输血效果进行比较。结果 对TEG和凝血试验指导心脏手术围术期用血率的比较,发现试验组指导冷沉淀25.9%和新鲜冰冻血浆33.3%的输注率明显低于对照组的68.5%,而血小板的输注率57.4%却明显高于对照组的20.4%;两组红细胞的输注率差异无统计学意义,但红细胞的输注量试验组（3.6＋1.6）明显低于对照组（5.8＋1.9）,试验组指导的新鲜冰冻血浆和冷沉淀的输注量也明显低于对照组（P〈0.05）;两组术中出血量、术后出血量、再次出血率方面,试验组均低于对照组（P〈0.05）。结论 血栓弹力图指导心脏手术患者围术期输血可减少血液制剂的使用量,并对疾病的预后转归优于常规凝血试验指导的用血,减少手术并发症及出血量,对指导临床成分输血具有重要意义,值得推广。

英文摘要：

Objective Investigate the relationship between thromboelastography and coagulation tests, and evaluate of two kinds of methods in guiding significance in cardiac surgery patients perioperative blood transfusion. Methods Analysis of 108 patients with cardiac surgery in September 2014-August 2016 treated in our hospitalwere randomLy divided into TEG detection guide blood transfusion group （experimental group） and coagulation test guide blood transfusion group （control group）, Respectively on two groups of blood transfusion rate, different components of blood transfusion and transfusion effect comparison.Results Through the comparison of the heart surgery peri- operative blood use rate guided by TEG and coagulation test, found the transfusion rate of experimental group guide cryopre- cipitate 25.9% and fresh frozen plasma（FFP） 33.3% was significantly lower than the control group 68.5% ,however, plate- let transfusion rate was significantly higher than the control group of 57.4% to 20.4%.There was no statistically significant difference of red cell suspension （RCS） infusion rate between two groups, but the RCS infusion quantity of experimental group（ 3.6± 1.6） was clearly lower than the control group（ 5.8± 1.9）, and the FFP and cryoprecipitate infusion quantity of experimental group was obviously lower than control group（P〈0. 05）, too. Experimental groups of intraoperative blood loss, postoperative blood loss and rebleeding rate was lower than control group （P〈 0. 05）. Conclusion That TEG guide cardiac surgery patients perioperative blood transfusion can reduce the use amount of blood products, and the prognosis of disease outcome is better than that of routine coagulation tests guidance.TEG can reduce the surgical complications and the bleeding amount, and it has great sense to guide clinical composition blood transfusion, so it is worth promoting.