摘要
目的 探讨血栓弹力图（TEG）检测妊娠晚期伴血小板减少的孕妇的凝血功能,评估其凝血功能,预测生产过程中出血的风险。方法 血小板减少的孕妇42例、血小板正常孕妇30例应用血栓弹力图仪检测R时间、K时间、Angle角、MA值以及CI值;72例标本均应用凝固法（磁珠法）测定凝血4项PT、APTT、TT、Fg及光散射法进行Plt计数检测。结果 血小板减少组Ⅰ（Plt〈50×10^9/L）、Ⅱ[Plt（50-100）×10^9/L]与正常对照组Ⅲ[Plt（100-300）×10^9/L]TEG参数MA值Ⅰ/Ⅱ组和Ⅰ/Ⅲ组两两比较差异均具统计学意义（P〈0.05）;K时间、Angle角及CI值Ⅰ/Ⅲ组间比较差异具统计学意义（P〈0.05）;R时间各组间两两比较差异均不具统计学意义（P〉0.05）;MA值、K时间及CI值在失血量≥800 m L组与〈800 m L组比较,A/C组、B/C组之间差异均具统计学意义（P〈0.05）;凝血4项中PT、APTT、TT血小板减少组与正常对照组之间两两比较,差异均不具统计学意义（P〉0.05）,Fg血小板减少组分别与正常对照组比较,差异均具统计学意义（P〈0.05）。结论 TEG结果中的MA值、CI指数、K时间是评估血小板减少孕妇生产过程中出血风险的主要指标,且各参数低至某一界限后出血量与死亡率明显增加。
Objective To utilize the thrombelastogram （TEG） to evaluate coagulation function during pregnancy and to predict the potential risk of hemorrhage during delivery . Methods Forty two pregnant women with thrombocytopenia, ineluding 20 with Ph 〈 50 × 10^9/L （group Ⅰ） and 22 with Ph （50 - 100） × 10^9/L （group Ⅱ ） and 30 normal pregnant with Ph （100 -300 × 10^9/L） （ group Ⅲ ） were measured and analyzed on reaction time （R） , clotting time （K）, α angle, maximum amplitude （MA） and coagulation index （CI）. Simultaneously, the PT, APTT, TT, Fg in above samples were determined with a freezing method （ magnetic beads method） and the Pit count was recorded using the light scattering method. Results Compared with group Ⅰ , significant difference （ P 〈 0. 05 ） was observed in MA and Fg. Significant difference （P 〈 0.05） was also observed in K, α angle and CI between groups Ⅰ and Ⅲ, but no significant difference was observed between groups Ⅰ and Ⅱ. In addition, the parameters according to the TEG is divided into groups A, B, C which were studied. From the correlation of MA, K and CI with the amount of hemorrhage, a significant difference in the amount of blood loss （ ≥800mL or 〈800 mL） was found between groups A and group C, and groups B and C, respectively （P 〈0. 05）. Conclusion TEG could be used as a useful indicator to monitor blood coagulation in pregnant women with thrombocytopenia. When the parameters are low to a certain limit, the amount of bleeding and the rate of mortality increase significantly.
作者
黄吉娥
涂飞
杨芳
曾小菁
祝丽丽
赵鲁强
HUANG Jie TU Fei YANG Fang ZENG Xiaojing ZHU Lili ZHAO Luqiang(Guizhou Medical University Affiliated Hospital, Guiyang 550004, China Guizhou Medical University.)
出处
《中国输血杂志》
CAS
北大核心
2016年第8期820-822,共3页
Chinese Journal of Blood Transfusion
关键词
血栓弹力图
妊娠
血小板减少
出血
thrombelastogram
pregnant
thrombocytopenia
bleeding
