血栓弹力图在毒蛇咬伤患者凝血检测的应用

The application of thrombelastogram in patients with snakebite

目的探讨血栓弹力图(TEG)在毒蛇咬伤患者凝血功能检测的应用价值。方法选取该院61例毒蛇咬伤患者作为实验组,47例健康体检者作为对照组,治疗前后抽取2组研究对象的静脉血作TEG、常规凝血、血常规检测,并对检验结果进行统计学分析。结果实验组反应时间(R)、共同作用(K)高于对照组,差异有统计学意义(P<0.05);血栓形成的速度(ɑ)、血栓最大幅度(MA)和综合凝血指数(CI)低于对照组,差异有统计学意义(P<0.05);常规凝血检测[凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)]与对照组比较,差异无统计学意义(P>0.05),纤维蛋白原(FIB)和血小板(PLT)计数低于对照组,差异有统计学意义(P<0.05)。结论 TEG各项参数灵敏地反映毒蛇咬伤患者机体的低凝状态,为临床判断病情、指导治疗提供一定的依据。

Objective To explore the application value of thrombelastogram （TEG） in the blood clotting function of patients with snakebite. Methods Sixty-one patients were selected as the experimental group,and 47 health examiners as control group,before and after treatment,blood samples were collected and were tested by using TEG,routine haemostatic assays and blood test,statistical analysis was performed on the test results. Results The R,K in snakebite group was higher than those in the control group,and the difference was statistically significant （ P 〈0.05）.The rate of thrombosis （α）,thrombosis biggest （MA） was lower than those in the control group,and the difference was statistically significant （ P 〈0.05 ）.Routine coagulation detection[prothrombin time （PT）,activated partial thromboplastin time （APTT）,thrombin time （TT）] difference of two set of patients have no statistics significance （ P 〉0.05）,the fibrinogen （FIB） and platelet （PLT） count were lower than those in the control group,and the difference was statistically significant （ P 〈0.05 ）,but it′s close to the normal reference range. Conclusion The index of TEG can respond more quickly to the coagulation state of the snake bite,to provide basis for clinical judgment of disease guidance.