血栓弹力图对临床输血的指导价值分析

Clinical value of thrombus elasto graph in guiding clinical transfusion

目的探讨血栓弹力图对临床输血的指导价值。方法抽选山西省人民医院2016年3月至2018年2月收治的术中需要输注血液制品的患者98例,采用随机数字表法分为观察组和对照组各49例。观察组采用血栓弹力图指标指导输血,对照组采用常规凝血指标指导输血。比较两组患者血液制品用量及术中、术后临床结局,并分析血栓弹力图相关参数(R、MA、Angle)与传统凝血指标的相关性。结果观察组术中出血量为(955.3±211.3)mL,明显少于对照组的(1145.8±201.2)mL,差异有统计学意义(t=4.570,P<0.05)。观察组使用悬浮红细胞(4.25±1.07)U、血红蛋白(Hb)(2.32±1.08)g、血小板(PLT)(2.14±0.58)U、新鲜冰冻血浆(217.5±21.3)mL,使用量均明显少于对照组,差异均有统计学意义(t=9.074、7.017、10.238、51.761,均P<0.05)。活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)与R均为正相关(r=0.46、0.35,均P<0.05);纤维蛋白原(FIB)与MA为正相关(r=0.37,P<0.05);PLT与Angle角、MA均为正相关(r=0.51、0.71,均P<0.05)。结论与常规凝血项指标相比,通过血栓弹力图对需手术输血患者合理使用血液制品具有指导价值,可以降低输血量,值得在临床推广。

Objective To explore the guiding value of thrombus elasto graph in clinical blood transfusion. Methods From March 2016 to February 2018, 98 patients who were given blood products in the People's Hospital of Shanxi Province were selected.The patients were divided into the observation group and the control group by the random stratification method, with 49 cases in each group.The observation group used thrombus elastograph to guide blood transfusion, while the control group used conventional coagulation indicators to guide blood transfusion.The amount of blood products and the clinical outcome of the two groups were compared, and the correlation between the parameters related to the thrombus map (R, MA, Angle) and the traditional blood coagulation index were analyzed. Results The blood loss during operation in the observation group was (955.3±211.3)mL, which was significantly less than (1 145.8±201.2)mL in the control group, and the difference was statistically significant (t=4.570, P<0.05). , The use of suspended red cells, Hb, PLT and fresh frozen plasma in the observation group were (4.25±1.07)U, (2.32±1.08)g, (2.14±0.58)U, (217.5±21.3)mL, respectively, which were significantly less than those in the control group (t=9.074, 7.017, 10.238, 51.761, all P<0.05). APTT and PT were positively correlated with R (r=0.46, 0.35, all P<0.05). FIB was positively correlated with MA (r=0.37, P<0.05). PLT was positively correlated with Angle angle and MA (r=0.51, 0.71, all P<0.05). Conclusion Compared with the conventional coagulation index, the thrombus map is of guiding value for the rational use of blood products for the patients who need the blood transfusion.It can help to reduce the amount of blood transfusion, and it is worth to be popularized in clinical practice.