血栓弹力图检测新型冠状病毒肺炎患者凝血功能的探讨分析

Investigation and Analysis of Thromboelastography in the Detection of COVID-19 Patients

自新型冠状病毒肺炎发生以来,疫情迅速蔓延,截至2020年3月22日,全球已有约19.6万人被确诊,累计死亡1.28万例,使得全球公共卫生机构处于高度的戒备状态。该病在临床上可分为轻型、普通型、重型和危重型,且感染患者多存在不同程度的凝血功能紊乱,尤其是凝血系统的活化,往往会造成纤溶系统的抑制,最终进展成为弥散性血管内凝血,其中36%的新型冠状病毒肺炎患者会出现D-二聚体和纤维蛋白降解产物(FDP)升高的现象,且并发症较多,救治难度大,病死率高。因此,深入研究新型冠状病毒肺炎患者的凝血特征,尤其是进一步发展成为脓毒症时凝血指标的变化,对阻止病情的恶化、提高治愈率、降低病死率有重要的意义。该文通过对新型冠状病毒肺炎致病机制和临床特征的研究,分析该病与脓毒症的相关性,重点探讨血栓弹力图在评价新型冠状病毒肺炎时凝血特点,尤其是发生血栓及出血的风险,进而为临床治疗提供参考依据。

Since the onset of COVID-19,the epidemic has spread rapidly,with an estimated 196000 confirmed cases and 12800 deaths worldwide as of March 22,2020.This has put public health agencies around the world on high alert.Most of the infected patients have different degrees of coagulation disorders,especially the activation of the coagulation system,which often leads to the inhibition of the fibrinolytic system,which eventually progresses to disseminated intravascular coagulation.Among them,36%of the COVID-19 patients will have increased D-Dimer and FDP.This makes the disease has more complications,and the treatment is difficult and the fatality rate is high.Therefore,in-depth study of the coagulation characteristics of COVID-19 patients,especially the changes in coagulation indicators when further developed into sepsis.It is of great significance to prevent the deterioration of the disease,improve the cure rate and reduce the case fatality rate.By studying the pathogenesis and clinical characteristics of COVID-19,this paper analyzed the correlation between the disease and sepsis,and focused on the discussion of thrombelastography in evaluating the coagulation characteristics of COVID-19,especially the risk of thrombosis and bleeding,so as to provide reference for clinical treatment.