血栓弹力图检测与常规凝血试验在重症感染患者血浆输注中的应用价值

宋佩

（渭南市中心医院输血科，陕西 渭南，714000）

浏览次数：152次 下载次数：312次

摘要：

目的 探讨血栓弹力图（TEG）检测与常规凝血试验在重症感染患者血浆输注中的应用价值。方法 选择我院收治的重症感染患者90例，均给予TEG检测与常规凝血试验，根据指导血浆输注方法的不同分为观察组和对照组，各45例。对照组 根据常规凝血试验结果指导血浆输注，观察组根据TEG检测结果指导血浆输注。另外，选择同期在我院接受健康体检的健康者45例为参考组，接受常规凝血试验和TEG检测。比较观察组和参考组患者的TEG检测各指标水平，并比较对照组和参考组患者的常规凝血检测各指标水平；同时，比较观察组和对照组患者的生存期。结果 与参考组比较，对照组的常规凝血检 测结果中APTT、PT、FDP、Fg、D-D水平及INR值均明显较高（P<0.05）。观察组的R值明显低于参考组，MA、CI值则明显高 于参考组（P<0.05）。观察组平均生存期和生存期中位数均明显长于对照组（P<0.05）。结论 当重症感染患者的TEG检测与常规凝血试验结果存在差异时，根据TEG检测结果指导临床血浆输注效果更优，能有效延长患者生存期，值得临床推广应用。

关键词：血栓弹力图；凝血试验；重症感染；血浆输注

中图分类号：R457.1文献标志码：A文章编号：2096-1413(2017)32-0056-02

Application value comparison between thromboela-stogram and conventional thrombotest in the guidance of plasma infusion of patients with severe infection
SONG Pei
(Department of Blood Transfusion, Weinan Central Hospital, Weinan 714000, China)

ABSTRACT: Objective To investigate the application value of thromboela-stogram (TEG) and conventional thrombotest in the guidance of plasma infusion of patients with severe infection. Methods Ninety cases of severe infection patients in our hospital were given TEG test and conventional thrombotest, patients were divided into observation group and control group according to different guidance of plasma infusion, with 45 cases in each group. The control group guided plasma infusion by conventional thrombotest results, and the observation group did it by TEG test results. Forty-five healthy subjects in our hospital at the same period were selected as the reference group, they received conventional thrombotest and TEG test. The indexes levels of TEG test between the observation group and the reference group, the indexes levels of conventional thrombotest between the control group and the reference group, and the survival time between control group and observation group were compared. Results Compared with the reference group, the levels of activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen degradation products (FDP), fibrinogen (Fg) and D-dimer (D-D) and international normalized ratio (INR) in the control group were higher (P<0.05). Compared with the reference group, the coagulation reaction time (R) was lower , the coagulation maximum amplitude (MA) and coagulation index (CI) were higher in the observation group (P<0.05). The mean survival time and median sunival time of the observation group were longer than those of the control group (P<0.05). Conclusion When the results of TEG test and conventional thrombotest in severe infection patients exist difference, clinical guidance of plasma infusion according to TEG test results has better effects and can effectively prolong survival time, which is worthy of clinical application and promotion.
KEYWORDS: thromboela-stogram (TEG); thrombotest; severe infection; plasma infusion

参考文献：
[1] 邹艳平,张瑚敏.血栓弹力图参数与脓毒血症抗感染无效的相关性 分析[J].四川医学,2016,37(9):1041-1043.
[2] 傅云峰,赵国胜,高萌,等.血栓弹力图在住院重症患者临床合理用 血中的应用[J].中华危重病急救医学,2016,28(5):396-400.
[3] 中华人民共和国卫生部.医院感染诊断标准(试行)摘登(2)(续前) [J].新医学,2005,36(12):735.
[4] 曾艳丽,高飞,魏君峰,等.血栓弹力图评价慢加急性肝衰竭患者的 凝血功能及预后研究[J].中华肝脏病杂志,2017,25(1):32-37.