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血栓弹力图在肝移植术后患者中的应用
Application of thromboelastography in patients after liver transplantation
文章发布日期:2015年01月14日  来源:  作者:袁宏香,张瑞金,齐玫,等  点击次数:1439次  下载次数:330次

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【摘要】:目的探讨血栓弹力图(TEG)检测对肝移植术后患者合理使用血液成分的指导作用。方法选取2013年11月-2014年4月在首都医科大学附属北京佑安医院就诊的35例肝移植术后患者,采集患者的血液样本分别进行TEG检测和传统凝血项检测。选取TEG检测参数[凝血反应时间(R)、凝固时间(K)、凝固角(Angle)、血栓最大幅度(MA)]和凝血项指标进行双变量的直线相关分析,并对TEG检测指导临床使用血成分及输血量与临床申请输注血液情况进行比较。计量资料比较采用配对t检验。结果 部分活化凝血酶原时间(APTT)、凝血酶原时间(PT)与R呈正相关(r值分别为0.69、0.41,P值分别为0.001和0.030);纤维蛋白原(FIB)与K呈负相关(r=-0.03,P=0.008);血小板(PLT)与Angle、MA呈正相关(r值分别为0.46、0.68,P值分别为0.029和0000);FIB与MA呈正相关(r=0.33,P=0.040)。R值在TEG肝素酶杯中和前后差异具有统计学意义(P=0.027)。结论TEG检测对肝移植术后患者合理使用血液成分具有指导意义。
【Abstract】:ObjectiveTo evaluate the value of thromboelastography (TEG) in guiding the proper use of blood components in patients after liver transplantation. MethodsThe blood samples from 35 patients after liver transplantation who visited our hospital from November 2013 to April 2014 were collected, in which TEG and conventional coagulation test were performed. The TEG parameters, such as reaction time of coagulation (R), clot formation time (K), Angle, and the maximum amplitude (MA), and coagulation parameters were subjected to bivariate linear regression analysis. The use of blood components and amount of blood transfusion following TEG′s instruction were compared with the clinical application. Comparison of continuous data was made by paired t test. ResultsActivated partial thromboplastin time and prothrombin time were positively correlated with R (r=0.69 and 0.41, P=0.001 and 0.030, respectively). Fibrinogen was negatively correlated with K (r=-0.03, P=0.008). Platelet was positively correlated with Angle and MA (r=0.46 and 0.68, P=0.029 and 0.000, respectively). Fibrinogen was positively correlated with MA (r=0.33, P=0.040). There was a significant difference in R value of TEG before and after the heparanase neutralization (P=0.027). ConclusionTEG has a clinical value in guiding the proper use of blood components in patients after liver transplantation.
【关键字】:肝移植;血栓弹力描记术;血液成分输血
【Key words】:liver transplantation; thrombelastography; blood component transfusion
【引证本文】:

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