摘要
目的探讨血栓弹力图检测在低血小板孕妇凝血功能中的价值以及通过体外模拟失血预测生产过程中出血的风险。方法选取65例产前患者,按入院时血小板计数分为3组：A组Plt〉100×109/L;B组Plt（50—100）×109/L;C组Plt〈50×109/L,将血样与0.9%Na Cl溶液以6∶4的稀释度进行稀释,将稀释前后的血样用血栓弹力图仪检测R时间、K时间、Angel（°）、MA值。比较低血小板组与对照组A组TEG指标的差异;比较各组稀释前后TEG指标的差异;比较每组不同分娩方式产后出血量。结果 TEG参数R值A/B比较差异无显著性（P〉0.05）,A/C比较差异具有显著性（P〈0.05）;MA值、K值、Angel（°）A/B和A/C两两比较差异均具有显著性（P〈0.05）。A组、B组稀释后与各自稀释前比较,各项参数差异均无显著性（P〉0.05）;C组稀释后与稀释前比较,R值差异无显著性（P〉0.05）,K值延长、Angel（°）缩小、MA值缩短,差异均具有显著性（P〈0.05）。剖宫产前预防性输注血小板后,术中出血量差异均无显著性（P〉0.05）。结论孕妇Plt〈50×109/L时,血液整体凝血功能为低凝状态,应用TEG可指导产前血小板的预防性输注。
Objective To explore the feasibility and significance of Thrombelastogram（ TEG） in blood coagulation analysis of pregnant women with thrombocytopenia and to predict the potential risk of hemorrhage during delivery by an in vitro model. Methods Sixty five antepartum patients were enrolled in the study and divided into 3 groups based on platelet counts： Group A with Plt higher than 100×109/L,Group B with Plt between 50×109/L and 100× 109/L and Group C with Plt lower than 50 × 109/L. Blood samples were diluted with 0. 9% saline at a 6 ∶ 4 ratio. Reaction time（ R）,clotting time（ K）,Angel（ °） and maximum amplitude（ MA） were measured by TEG. The TEG indicators of the thrombocytopenia groups were compared with that of the control group and intergroup comparisons were made as well; The bleeding of different patterns of delivery in 3 groups were compared. Results R values showed no significant difference（ P〈0. 05） between group A and B while it was statistically significant（ P〈0. 05） between group A and C; MA、K、Angel（ °） showed significant difference（ P〈0. 05） between both group A and B/groups A and C. The TEG indicators showed no significant difference（ P〈0. 05） in group A and B; R was not significant difference（ P〈0. 05） in group C; K were increased while α and MA were decreased and the changes were all statistically significant（ P〈0. 05）. Because of preoperative platelet transfusion,the risk of postpartum hemorrhage was not significant difference（ P〈0. 05） in the 3 groups. Conclusion When the platelet count of a pregnant women drops below 50×109/L,it＇s considered coagulation-incapable and TEG can be used to guide the platelet infusion.
作者
王莎
李红霞
史连义
武媛媛
李悦
WANG Sha;LI Hongxia;SHI Lianyi;WU Yuanyuan;Li Yue(CNPC Central Hospital,Langfang 065000,China)
出处
《中国输血杂志》
CAS
2018年第6期637-639,共3页
Chinese Journal of Blood Transfusion
关键词
血栓弹力描记图
妊娠
血小板减少
凝血
thrombelastogram
pregnant
thrombocytopenia
blood coagulation
