血栓弹力图在肝移植围术期凝血功能评价中的应用

Application of Thromboelastograms in the Evaluation of Perioperative Coagulation Function in Liver Transplantation

目的应用血栓弹力图(TEG)结合传统凝血指标,评估肝移植围术期凝血状态,指导围术期合理输血。方法选取2017年6月-2019年5月于本院进行肝移植手术的患者32例,分别在手术前、术中及术后24h抽取血液标本,检测凝血四项和TEG,根据TEG结果指导血液成分输注,术后评价凝血功能的调控效果。结果经TEG指导血液成分输注后,32例患者在术后24h的凝血四项及TEG检测结果与术前检测均无统计学意义(P>0.05),术后均未发生大出血、血栓等凝血功能异常。结论使用TEG监测肝移植围术期的凝血状态,可以很好指导血液成分合理输注。

Objective To evaluate the coagulation status during the perioperative period of liver transplantationby using thromboelastic diagram(TEG)combinated with traditional coagulation indexes,and to guide the reasonable transfusion during the perioperative period.Methods 32 patients who underwent liver transplantation in the Department of Organ Transplantation of Zhengzhou People’s Hospital from June 2017 to May 2019 were selected as research study.Blood samples were collected before,during and 24 hours after the operation,respectively,and the four coagulation items and TEG were detected.Blood composition infusion was guided according to the TEG results,and the regulation effect of coagulation function was evaluated after the operation.Results After the infusion of blood components guided by TEG,the four coagulation items and TEG test results of 32 patients were not statistically significant compared with the preoperative test at 24 hours after the operation(P>0.05),and no major bleeding,thrombus and other coagulation function abnormalities occurred after the operation.Conclusion The use of TEG to monitor the coagulation status during the perioperative period of liver transplantation can be a good guide for the rational infusion of blood components.