TEG指导创伤失血性休克患者输血的应用评价

Evaluation on the Application of TEG in Blood Transfusion in Patients with Traumatic Hemorrhagic Shock

【目的】探讨血栓弹力图(TEG)在创伤失血性休克患者输血中的指导意义。【方法】回顾性分析2018年1月至2020年12月本院收治的104例创伤失血性休克患者。其中对照组52例未行TEG检查常规输血;观察组52例行TEG检查在相关指标指导下输血。比较两组患者输血前后凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)]、观察组输血前后TEG指标(R值、K值、α角及MA值)、两组血液成分输注量以及预后情况。【结果】两组输血后APTT、PT、TT均校输血前减低(P<0.05),FIB较输血前增加(P<0.05),且输血后观察组较对照组APTT、PT、TT减低(P<0.05),FIB增加(P<0.05)。观察组输血后R值、K值较前减低(P<0.05),α角、MA值较前增加(P<0.05)。观察组红细胞及血浆用量低于对照组(P<0.05),而冷沉淀和血小板用量均高于对照组(P<0.05)。【结论】TEG能为创伤失血性休克患者输血提供合理策略,更有效的改善凝血功能,具有较大的临床价值。

【Objective】To explore the significance of thromboelastography(TEG)in blood transfusion of patients with traumatic hemorrhagic shock.【Methods】A total of 104 Patients with traumatic hemorrhagic shock trea ted in our hospital from January 2018 to December 2020 were selected.Among them,52 cases in the control group did not undergo TEG examination before rec&ving blood transfusion,while 52 cases in the observation group received blood transfusion under the guidance of TEG.The coagulation function tests such as activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT)and fibrinogen(FIB),the TEG test results(R value.K value,α angle and MA value)before and after blood transfusion,the amount of blood component infusion and the prognosis of the two groups were compared.【Results】The levels of APTT,PT,TT after blood transfusion in the two groups were lower than that before blood transfusion(P<0.05),while the FIB level was higher(P<0.05).After blood transfusion,the levels of APTT,PT,and TT in the observation group were lower than those in the control group(P<0.05),and the FIB level in the observation group was higher than that in the control group(P<0.05).In the observation group,the R value and K value after blood transfusion were lower than before(P<0.05),and α angle and MA value were increased(P<0.05).The amount of RBCs and plasma in the observation group was lower than that of the control group,while the amount of cryoprecipitate and platelets was higher than that in the control group(P<0.05).【Conclusion】TEG can provide a reasonable strategy for blood transfusion in patients with traumatic hemorrhagic shock by improving blood coagulation function more effectively,which has great clinical value.