血栓弹力图在患儿凝血功能检测中的应用进展

Thromboelastography: clinical progress of coagulation tests in pediatric patients

人类凝血系统在长期演变过程中,形成了1个复杂的动态平衡机制,这对维持机体稳态至关重要。而凝血系统的波动将导致严重疾病。众所周知,3—6月龄的婴儿凝血系统尚未完全成熟,新生儿及儿童生理性凝血与成人亦有所不同,新生儿常出现常规凝血试验指标异常。但其和临床症状之间的关系,如血栓形成或出血风险相关性依然不明确。人们对新生儿和儿童凝血功能的认识仍旧不足。血栓弹力图(thromboelastography,TEG)是血凝块形成动力学的描计图,能够反映血栓形成及降解的凝血过程全貌,属于血液流变学检测,一定程度上弥补了传统常规凝血试验的不足,为更好地评估患儿的凝血功能提供了有力保障。且相对常规凝血试验检查,TEG所需标本量小,适用于对儿科患者凝血状态的评估。

The human coagulation system is a complex, dynamic and balanced system, which is vital to maintain a good physical condition. While coagulation system in disorder may cause serious diseases. It is well-known that the coagulation system of infants aged from 3 to 6 months is not completely mature, and the physical coagulation in newborns and children are different from that of adults. Newborns often demonstrate abnormalities in conventional coagulation tests(CCTs). However, the relationship between the abnormalities and clinical symptoms remains unclear, such as the risk of thrombosis or bleeding. We are still insufficient understanding in coagulation function with newborns and children. Thromboelastography(TEG) is a laboratorial test that measures viscoelastic changes of the entire clotting process. It provides a more comprehensive global coagulation assessment than routine tests. Moreover, compared with CCTs, TEG requires a small amount of specimens, and it′s especially suitable for assessing the coagulation status of pediatric patients.