摘要
客观 Intra 起作用的 coagulopathy 与血损失和病人的预后有一种靠近的关系。Rapid-thrombelastography (r 两岁的羊) 是对凝结畸形并且也的一个全面评价为构造输血的一个有效方法。调查 r 两岁的羊的关联的尝试与在北京联合医学院医院里从 1 月 15 日经历了 transphenoidal 垂体切除术和颅骨切开术到 2013 年 4 月 30 日的 intra 起作用的 hemorrhage.Methods 病人一起索引的这研究被招募。所有病人有外科手术前、手术后的 r 两岁的羊和常规凝结测试(CCT ) 。病人信息和估计的血体积的一个百分比被记录的 intra 起作用的血损失。枪兵关联分析被用于在 r 两岁的羊或 CCT 和 intra 起作用的血损失发现在索引之间的关系。r 两岁的羊的重要相关索引进一步用 181 个病人的一个总数参予了的线性回归 analysis.Results 被调查这研究。反映纤维蛋白原水平和功能的 -angle, 的 Intra 起作用的变化，是显著地与血损失相关的唯一的 r 两岁的羊索引(P=0.013， r= 0.184 ) ，因此在凝结上质问 intra 起作用的出血的效果的当前的实验认知。当 intra 起作用的血损失增加了，角度减少了，并且估计的血体积(EBV ) 的每 1% 损失导致了角度的 0.60 度减少。至于 CCT 结果，纤维蛋白原和血小板计数的变化显著地也与血损失被相关(P=0.015 和 P=0.001，分别地) 是的 -angle, 的结论仙子起作用的变化 r 两岁的羊的一个索引，与 intra 起作用的血损失展出了重要否定关联。而不是 clotting 因素，纤维蛋白原上的出血的影响应该被细看。
Objective Intra-operative coagulopathy has a close relationship with blood loss and the prognosis of patients. Rapid-thrombelastography （r-TEG） is a comprehensive assessment of coagulation abnormalities and also an effective way for constructing blood transfusion. This study attempts to investigate the correlation of r-TEG indices with intra-operative hemorrhage. Methods Patients who underwent transphenoidal hypophysectomy and craniotomy from January 15 to April 30, 2013 in Peking Union Medical College hospital were recruited. All patients had pre- and post-operative r-TEG and conventional coagulation tests （CCTs）. Patients’ information and intra-operative blood loss as a percentage of estimated blood volume were recorded. Spearman’s correlation analyses were used for discovering the relationship between indices in r-TEG or CCTs and the intra-operative blood loss. The significant correlated index of r-TEG was further investigated using linear regression analysis. Results A total of 181 patients participated in this study. Intra-operative change of α-angle, which reflects the fibrinogen level and function, was the only r-TEG index that correlated with blood loss significantly （P=0.013, r= ？0.184）, thus challenging the current empirical cognition of the effects of intra-operative hemorrhage on coagulation. As intra-operative blood loss increased, α-angle decreased, and every 1% loss of estimated blood volume （EBV） led to 0.60 degree decrease of α-angle. As for CCT results, changes of fibrinogen and platelet count were also significantly correlated with blood loss （P=0.015 and P=0.001, respectively）.Conclusions Peri-operative change of α-angle, as an index of r-TEG, exhibited a significant negative correlation with intra-operative blood loss. The impact of hemorrhage on fibrinogen, instead of clotting factors, should be scrutinized.
