东篱科研大数据发现系统（DRDS）

位置：成果数据库 > 期刊 > 期刊详情页

血栓弹力图指导主动脉夹层患者术后成分输血作用的探讨

ISSN号：1004-2806
期刊名称：《临床血液学杂志：输血与检验》
时间：0
分类：R457.1[医药卫生—治疗学;医药卫生—临床医学]
作者机构：南京医科大学第一附属医院输血科,南京210029
相关基金：南京市科技计划项目资助（No：201303037）

关键词：血栓弹力图, 主动脉夹层, 手术, 成分输血, thromboelastogram, blood component transfusion, surgical operation, aortic dissection

中文摘要：

目的：探讨血栓弹力图（TEG）在指导主动脉夹层患者术后成分输血中的意义。方法：回顾性分析近2年成功进行手术治疗的50例主动脉夹层患者,比对术前和术后各项TEG检测参数及传统血常规和凝血项检测参数,并将术后各项参数与术后输注血浆、血小板和冷沉淀量进行相关性分析。结果：与术前相比,术后TEG参数中的R和K明显延长（P〈0.01,P〈0.05）,α-Angle和MA明显减小（P〈0.01）,CI明显降低（P〈0.01）,术后凝血5项中的凝血酶原时间（PT）、激活部分凝血酶时间（APTT）、纤维蛋白原（FIB）、凝血酶时间（TT）明显延长（P〈0.01）,血小板计数（PLT）计数明显降低（P〈0.01）。术后血浆输注量与各项凝血参数均无相关性,血小板输注量与MA和PLT计数有显著相关性（P〈0.01,P〈0.05）,冷沉淀输注量与K值、α-Angle和APTT有显著相关性（P〈0.01,P〈0.01,P〈0.05）。结论：TEG可以提示主动脉夹层手术患者术后的凝血功能障碍,MA值可以指导血小板的输注,α-Angle和K值可以作为术后冷沉淀输注的重要参考,并应注意R值在指导血浆输注中的意义。

英文摘要：

Objective：To discuss the guidance of thromboelastogram（TEG） in blood component transfusion atter surgical operation in patients with aortic dissection.Method：Fifty cases of aortic dissection,who received successful operation in the past two years in our hospital,were retrospectively analyzed.The preoperative and postoperative TEG parameters and traditional blood and coagulation test parameters were analyzed.The correlation analyses were performed between these postoperative parameters and postoperative transfusion of plasma,platelets and cryoprecipitate.Result：Compared with the preoperative parameters,the postoperative TEG parameters of R and K were significantly prolonged（P〈0.01,P〈0.05）,α-Angle,MA and CI were significantly decreased（P〈0.01）.The values of PT,APTT,TT and INR were significantly prolonged（P〈0.01）.While the platelet counts decreased significantly after surgical operation（P〈0.01）.No correlation was found between the coagulation parameters and postoperative plasma transfusion.Platelet transfusion was significantly correlated with MA value and platelet counts（P〈0.01,P〈0.05）,The cryoprecipitate transfusion had significant correlation with K value,α-Angle and APTT（P〈0.01,P〈0.01,P〈0.05）.Conclusion：TEG could suggest the dysfunction of blood coagulation after surgical operation in patients with aortic dissection.The MA value could guide the platelet transfusion.The a-Angle and K value could be used as an important reference for cryoprecipitate transfusion.And surgeons should pay attention to the R value in the guidance of plasma transfusion.

同期刊论文项目