TEG在脓毒症患者CRRT肝素抗凝监测中的应用价值

Application Value of Thrombelastogram in Monitoring CRRT Heparin Anticoagulation in Patients with Sepsis

目的:评价血栓弹力图(TEG)在脓毒症患者连续肾脏替代疗法(CRRT)肝素抗凝监测中的应用价值。方法:纳入2018年3月至2021年3月厦门医学院附属第二医院收治的行CRRT治疗的脓毒症患者80例,以抽签法分为对照组〔监测活化部分凝血活酶时间(APTT),40例〕和观察组(在对照组基础上应用TEG,40例),分析比较两组患者出血事件发生率、肝素用量和滤器使用时间。结果:观察组患者出血事件发生率为5.0 %,与对照组的15.0 %比较,差异无统计学意义(P>0.05)。观察组患者肝素用量与对照组比较,差异无统计学意义(P>0.05);观察组患者滤器使用时间长于对照组,差异具有统计学意义(P<0.05)。结论:TEG是一种快速、有效的监测措施,能够为脓毒症患者的CRRT肝素抗凝提供监测手段,确保脓毒症患者CRRT治疗顺利进行,从而改善患者预后。

Objective To evaluate the value of thrombelastogram (TEG) in monitoring heparin anticoagulation in patients with sepsis after continuous renal replacement therapy (CRRT).Methods A total of 80 sepsis patients treated with CRRT from March 2018 to March 2021 in the Second Affiliated Hospital of Xiamen Medical College were enrolled.They were divided by lottery into control group[monitoring activated partial thromboplastin time (APTT),40 cases]and observation group (using TEG on the basis of the control group,40 cases).The incidence of bleeding events,the dosage of heparin and the use time of filter were analyzed and compared between the two groups.Results The incidence of bleeding events in the observation group was 5.0 % (2/40),which was not statistically significant compared with 15.0 % in the control group (P > 0.05).There was no significant difference in heparin dosage between the observation group and the control group (P > 0.05).The filter use time in the observation group was longer than that in the control group,and the difference was statistically significant (P < 0.05).Conclusion TEG is a rapid and effective monitoring measure,which can provide monitoring means for CRRT anticoagulation in patients with sepsis,ensure the smooth treatment of CRRT in patients with sepsis,and improve the prognosis of patients.