摘要
目的:分析血栓弹力图检查参数与胎盘早剥严重程度的关系及对胎儿窘迫的预测价值。方法:选择102例胎盘早剥孕妇(观察组)作为研究对象,其中轻型57例、重型45例;另选同期的102例正常妊娠孕妇作为对照组。检测两组血栓弹力图检查参数[凝血反应时间(R值)、凝血时间(K值)、血细胞凝集块形成速率(α角)、血栓最大弹力度(MA值)、凝血综合指数(CI值)],分析血栓弹力图检查参数与分娩出血量的关系,使用受试者工作特征(ROC)曲线分析血栓弹力图检查参数对胎儿窘迫的预测价值。结果:观察组R值、K值均长于对照组,α角、MA值、CI值均小于对照组(均P<0.05);在观察组中,重型胎盘早剥孕妇R值、K值均长于轻型胎盘早剥孕妇,α角、MA值、CI值均小于轻型胎盘早剥孕妇(均P<0.05);经Pearson相关性分析,胎盘早剥孕妇分娩出血量与R值、K值呈正相关(P<0.05),与α角、MA值、CI值呈负相关(P<0.05);经多因素Logistic回归分析,血栓弹力图中R值、K值均是胎盘早剥孕妇发生胎儿窘迫的独立预测因素(均P<0.05);经ROC曲线分析,胎盘早剥孕妇血栓弹力图中R值联合K值预测胎儿窘迫的ROC曲线下面积(AUC)为0.924。结论:胎盘早剥孕妇血栓弹力图检查参数明显异常,与病情严重程度密切相关,在血栓弹力图中R值联合K值预测胎儿窘迫的效能更佳。
Objective:To analyze the relationship between thrombelastography parameters and the severity of placental abruption and its predictive value for fetal distress.Methods:A total of 102 pregnant women with placental abruption(observation group)were selected as the research subjects,including 57 mild cases and 45 severe cases.Another 102 normal pregnant women were selected as the control group.The thrombelastography parameters[coagulation reaction time(R value),coagulation time(K value),hemagglutination block formation rate(αAngle),maximum thromboelastic force(MA value),coagulation comprehensive index(CI value)]of the two groups were detected,and the relationship between thrombelastography parameters and labor blood loss was analyzed.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of thrombelastography parameters for fetal distress.Results:The R and K values of the observation group were longer than those of the control group,and theαangle,and MA and CI values were lower than those of the control group(all P<0.05).In the observation group,the R and K values of severe placental abruption women were longer than those of mild placental abruption women,and theαangle,MA and CI values were lower than those of mild placental abruption women(all P<0.05).Pearson correlation analysis showed that the amount of blood loss was positively correlated with R value and K value,and negatively correlated withαangle,MA value and CI value(all P<0.05).Multivariate Logistic regression analysis showed that R value and K value in thromboelastography were independent predictors of fetal distress in pregnant women with placental abruption(all P<0.05).According to ROC curve analysis,the area under ROC curve(AUC)of R value combined with K value for predicting fetal distress in thromboelastography of pregnant women with placental abruption was 0.924.Conclusion:The parameters of thromboelastography in pregnant women with placental abruption are obviously abnormal,which is closely related to the severity of the disease.The R value combined with K value in thromboelastography is better in predicting fetal distress.
作者
张燕
朱俊美
崔静
ZHANG Yan;ZHU Junmei;CUI Jing(The Second Department of Obstetrics,Xi’an International Medical Center Hospital,Xi’an 710100,China)
出处
《陕西医学杂志》
CAS
2023年第5期553-557,共5页
Shaanxi Medical Journal
基金
陕西省自然科学基础研究计划项目(2018JM7135)。
关键词
胎盘早剥
严重程度
血栓弹力图
胎儿窘迫
分娩出血量
预测
Placental abruption
Degree of severity
Thrombelastography
Fetal distress
Blood loss during delivery
Prediction
