摘要
目的探究血栓弹力图(TEG)联合血小板计数(PC)用于指导创伤性失血患者血浆输注中的临床效果。方法选取2019年1月至2022年12月安徽省太和县人民医院收治的98例创伤性失血患者为研究对象,采用随机表法随机分为联合组和对照组,各49例。对照组采用PC监测指导对患者输注血浆,种类包括新鲜冰冻血浆、红细胞悬浮液及血小板三种血制品,联合组在对照组的基础上,加以TEG监测指导输注血浆。比较两组输注血浆时新鲜冰冻血浆、红细胞悬浮液及血小板三种血制品的用量;比较两组的活化部分凝血活酶时间(APTT)、血浆凝血酶原时间(PT)、凝血酶时间(TT)及纤维蛋白原(FIB)四项凝血指标;比较患者输注血浆后1d内的出血量情况及出血时间。结果输注血浆后,联合组的新鲜冰冻血浆、红细胞悬浮液及血小板使用量均低于对照组,差异有统计学意义(t=28.393,9.998,17.323,P<0.05);输注血浆后,两组的APTT、PT、TT水平均低于输注血浆前,FIB水平均高于输注血浆前,且联合组变化幅度更大,差异有统计学意义(t=10.740,4.973,8.251,11.242,P<0.05);联合组患者输注血浆后1d内出血量低于对照组,差异有统计学意义(t=15.571,P<0.05)。结论TEG联合血小板计数(PC)指导创伤性失血患者的临床血浆输注效果优于单用PC指导,且患者输注血浆后出血量较少,对于临床指导创伤性失血患者的血浆输注具有一定的价值。
Objective To explore the clinical effect of TEG combined with platelet count(PC)in guiding plasma infusion in patients with traumatic blood loss.Methods A total of 98 patients with traumatic blood loss admitted to Taihe County People's Hospital of Anhui Province from December 2019 to December 2022 were selected as the study objects,and were randomly divided into a combination group and a control group by random table method,with 49 cases in each group.The control group was guided by PC monitoring for plasma infusion,including fresh frozen plasma,red cell suspension and platelets,while the combined group was guided by TEG monitoring on the basis of the control group.The dosage of fresh frozen plasma,red cell suspension and platelets during plasma infusion was compared between the two groups.Activated partial thromboplastin time(APTT),plasma prothrombin time(PT),thrombin time(TT)and fibrinogen(FIB)were compared between the two groups.Blood loss and bleeding time within 1 day after plasma infusion were compared.Results After plasma infusion,the usage of fresh frozen plasma,red cell suspension and platelets in the combination group was lower than those in the control group,with statistical significance(t=28.393,9.998,17.323,P<0.05).After plasma infusion,APTT,PT and TT levels in the two groups were lower than before plasma infusion,and FIB levels were higher than that before plasma infusion,and the change range was greater in the the combination group,with statistical significance(t=10.740,4.973,8.251,11.242,P<0.05).The blood loss in the combined group was lower than that in the control group within 1 day after plasma infusion,with statistical significance(t=15.571,P<0.05).Conclusion TEG combined with PC guidance on clinical plasma infusion in patients with traumatic blood loss is better than that of platelet count guidance alone,and the blood loss after plasma infusion is less,which has certain value for clinical guidance on plasma infusion in patients with traumatic blood loss.
作者
庞辉
王小影
张健
PANG Hui;WANG Xiaoying;ZHANG Jian(Department of Blood Transfusion,Taihe County People's Hospital,Taihe,Anhui,China,236600)
出处
《分子诊断与治疗杂志》
2023年第9期1595-1598,共4页
Journal of Molecular Diagnostics and Therapy
基金
安徽省医学会急诊临床研究项目(Ky2018019)。
