血栓弹力图在评价妊娠合并血小板减少症患者血小板输注的作用

The role of thrombelastography in the evaluation of platelet transfusion in pregnant patients with thrombocytopenia

目的分析妊娠合并血小板减少症患者使用血栓弹力图指导血小板输注的作用。方法选择青岛大学附属医院2015—2016年住院治疗的妊娠合并血小板减少症患者76例为研究对象,其中40例病人为研究组,36例为对照组。对照组进行血常规、血凝常规检测,研究组加做血栓弹力图检测,并记录相关临床资料,比较两组患者分娩方式、术中出血情况、输血情况及实验室检测结果差异。结果研究组与对照组血小板(platelets,Plt)计数、血红蛋白数值、血细胞比容(HCT)、凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)及纤维蛋白原(fibrinogen,Fg)比较,差异均无统计学意义(P>0. 05);研究组剖宫产率(32. 5%)与对照组(27. 8%)比较无统计学差异(P>0. 05);血小板输血人数研究组明显少于对照组(P <0. 05);术中出血量及新生儿Apgar评分比较,两组差异无统计学意义(P>0. 05)。结论妊娠合并血小板减少症患者进行血栓弹力图检测可以更准确地反映凝血功能,指导临床合理输注血小板。

Objective To investigate the role of thrombelastography(TEG) in platelets transfusion and corresponding applications in pregnant patients with thrombocytopenia. Methods 76 pregnant patients with thrombocytopenia hospitalized in the Affiliated Hospital of Qingdao University during 2015 to 2016 were enrolled in this study. 40 patients and the other 36 patients formed the experimental group and the control group,respectively. The control group was subjected to routine blood tests and blood clotting tests. The experimental group was additionally tested with TEG. The relevant clinical data were recorded. The way of delivery,intraoperative bleeding,blood transfusion and differences in laboratory test results between the two groups were compared. Results There were no significant differences between the experimental group and the control group in platelet(Plt) counts,hemoglobin values,hematocrit(HCT),prothrombin time(PT),activated partial thromboplastin time(APTT) and fibrinogen(Fg)(P>0. 05).The cesarean section rate(32. 5%) in the experiment group was not significantly different from the control group(27. 8%)(P>0. 05). The number of patients with platelet transfusion was significantly less in the experiment group than the control group(P<0. 05). The amount of intraoperative bleeding and the neonatal Apgar score were not significantly different between the two groups(P>0. 05). Conclusion TEG can more accurately reflect the coagulation function and thus better guide the reasonable platelet transfusion in pregnancy patients with thrombocytopenia.