血栓弹力图在监测产科大出血临床输血中的应用

Application of Thrombelastogram in Monitoring Clinical Blood Transfusion of Obstetric Massive Hemorrhage

目的:探究血栓弹力图在监测产科大出血临床输血中的应用。方法:选取2019年6月至2020年12月在惠州市第三人民医院实施输血治疗的82例产科大出血患者,按照简单随机数字表法分为对照组和观察组,各41例。对照组采用常规凝血检测指导输血,观察组采用血栓弹力图检测指导输血。评估两组患者血液制剂使用量、不同时点凝血状态及临床结局。结果:观察组患者悬浮红细胞、新鲜冰冻血浆、冷沉淀凝血因子、血小板等血液制剂使用量均低于对照组,差异具有统计学意义(P<0.05);两组患者不同时点凝血状态情况,差异无统计学意义(P>0.05);观察组患者术后出血量显著低于对照组,差异具有统计学意义(P<0.05);两组患者的住院时间与病死率比较,差异无统计学意义(P>0.05)。结论:血栓弹力图监测产科大出血临床输血能有效减缓患者术后的出血量,减少血液制剂的使用量,促进患者痊愈。

Objective To explore the application of thrombelastogram in monitoring clinical blood transfusion of obstetric massive hemorrhage.Methods From June 2019 to December 2020,82 patients with obstetric hemorrhage receiving blood transfusion treatment in the Third People’s Hospital of Huizhou were selected and divided into control group and observation group according to the simple random number table method,with 41 cases in each group.Routine coagulation test was used to guide blood transfusion in the control group,and thrombelastogram test was used to guide blood transfusion in the observation group.The amount of blood preparation,coagulation status at different time points and clinical outcomes were evaluated.Results The usage of blood preparations such as suspended red blood cells,fresh frozen plasma,cryoprecipitate coagulation factor and platelets in observation group was lower than that in control group,the difference was statistically significant(P<0.05);There was no significant difference in coagulation status between the two groups at different time points(P>0.05);The amount of postoperative bleeding in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05);There was no significant difference in length of stay and mortality between the two groups(P>0.05).Conclusion Thrombelastogram monitoring of clinical blood transfusion for obstetric massive hemorrhage can effectively slow down postoperative blood loss,reduce the use of blood preparations,and promote the recovery of patients.