血栓弹力图评价围术期凝血纤溶功能的变化

Evaluation of Coagulation and Fibrinolysis in Patients Undergoing Perioperative Period by Thromboelastography

目的观察血栓弹力图(TEG)评价围术期凝血纤溶功能的变化。方法回顾分析2017年4月至2019年4月笔者所在医院收治的100例外科手术患者的临床资料,分析术前、术中3 h、术后第1天、第3天患者的凝血纤溶功能变化。结果与手术前比较,术中、aPTT和PT逐有下降,术后第1天、术后第3天呈逐渐上升;术后第1天和术后第3天患者的Fbg含量逐渐降低,与术前、术中比较,差异显著(P<0.05);术中、术后第1天、术后第3天的R值和K值均逐渐增加,但与术前比较并无明显差异(P>0.05);患者术中的CI水平与术前相比明显降低,有显著性差异(P<0.05),并且术后CI水平持续降低,但与术中比较并无显著性差异(P>0.05);术后第1天患者的LY30增加,与术前和术中相比较均具有显著差异(P<0.05)。结论TEG是评价围术期凝血纤溶功能的良好方法,可为临床治疗提供参考。

Objective To evaluate the changes in coagulation and fibrinolysis in the perioperative period by thromboelastography(TEG).Methods The clinical data of 100 surgery patients from April 2017 to April 2019 were reviewed and analyzed.The changes of coagulation and fibrinolysis were analyzed before operation,3 h in operation,first days after operation and third days after operation.Results Before and after operation,aPTT and PT were decreased at first days after operation and third days after operation gradually increased,but the content of Fbg decreased gradually,and the difference was significant(P<0.05).During the operation,the values of R and K increased gradually on the first day and the third day after operation,but there was no significant difference between the two groups(P>0.05),and the CI level of the patients during operation was significantly lower than that before operation(P<0.05).There was no significant difference in CI level between the two groups(P>0.05),and the level of LY30 increased on the first day after operation,which was significantly higher than that before and during operation(P>0.05).There was significant difference between the two groups(P<0.05).Conclusion TEG is a good method to evaluate the coagulation and fibrinolysis function in the perioperative period can provide reference for clinical treatment.