血栓弹力图指导血小板输注在恶性肿瘤患者中的应用效果分析

Analysis of the application effect of thromboelastography-guided platelet transfusion in patients with malignant tumor

目的探讨血栓弹力图(TEG)指导血小板输注在恶性肿瘤患者中的应用效果。方法将2021年3月至2022年2月收治的30例恶性肿瘤患者纳入对照组,2022年3月至2023年2月收治的30例恶性肿瘤患者纳入观察组。对照组患者采用传统方法指导血小板输注,观察组患者采用TEG指导血小板输注,评估和比较两组患者的输注效果、血小板输注相关情况、凝血功能指标及不良事件发生情况。结果观察组患者1 h血小板计数纠正后增多指数(CCI)、24 h CCI及输注有效率均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者血小板输注量、输注次数均明显少于对照组,输注所需总时间明显短于对照组,差异均有统计学意义(P﹤0.01)。输注后,两组患者纤维蛋白原(FIB)水平均升高,凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及凝血酶时间(TT)均缩短,且观察组患者FIB水平高于对照组,PT、APTT、TT均短于对照组,差异均有统计学意义(P﹤0.05)。观察组患者不良事件总发生率低于对照组,差异有统计学意义(P﹤0.05)。结论在恶性肿瘤患者接受血小板输注时,应用TEG能够显著改善输注效果,并更有效地纠正凝血功能异常状态,有助于降低出血等不良事件的发生率。

Objective To investigate the application effect of thromboelastography(TEG)-guided platelet transfusion in patients with malignant tumors.Method Thirty patients with malignant tumors treated from March 2021 to February 2022 were included in the control group,and 30 patients with malignant tumors treated from March 2022 to February 2023 were included in the observation group.Patients in the control group received traditional methods-guided platelet transfusion,and patients in the observation group received TEG-guided platelet transfusion.The transfusion effects,platelet transfusion-related conditions,coagulation function indicators,and adverse events of the two groups were evaluated and compared.Result The 1-hour corrected count increment(CCI),24-hour CCI,and transfusion effectiveness of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The platelet transfusion volume,number of transfusions in the observation group were significantly less than those in the control group,and total time required for transfusion was shorter than that in the control group,and the differences were statistically significant(P<0.01).After infusion,the levels of fibrinogen(FIB)in both groups were increased,and the prothrombin time(PT),activated partial thromboplastin time(APTT),and thrombin time(TT)were shortened,and the level of FIB in the observation group was higher than that in the control group,the PT,APTT,TT in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The total incidence rate of adverse events in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion When patients with malignant tumors receive platelet transfusions,the application of TEG could significantly improve the transfusion effect,correct abnormal coagulation status more effectively,and help reduce the incidence of adverse events such as bleeding.