|本期目录/Table of Contents|

[1]胡维,沈国栋,张杰,等.肝移植术后血栓弹力图与凝血试验相关因素分析[J].医学研究与战创伤救治(原医学研究生学报),2019,21(4):378-381.[doi:10.3969/j.issn.1672-271X.2019.04.010]
　HU Wei,SHEN Guo-dong,ZHANG Jie,et al.The correlation analysis of thromboelastography and coagulation function test of patients after liver transplantation[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2019,21(4):378-381.[doi:10.3969/j.issn.1672-271X.2019.04.010]
点击复制

肝移植术后血栓弹力图与凝血试验相关因素分析()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第21卷
期数:
2019年4期
页码:
378-381
栏目:
临床研究
出版日期:
2019-07-20

文章信息/Info

Title:
The correlation analysis of thromboelastography and coagulation function test of patients after liver transplantation
文章编号:
1672-271X（2019）04-0378-04
作者:
胡维;  沈国栋;  张杰;  孙融;  周楚瑶;  孙玲玲;  黄亚;  丁媛;  王琴
作者单位：210002 南京，南京中医药大学附属八一医院重症医学科（胡 维、张 杰、孙 融、周楚瑶、孙玲玲、黄 亚、丁 媛、王 琴），输血科（沈国栋）
Author(s):
HU Wei;  SHEN Guo-dong;  ZHANG Jie;  SUN Rong;  ZHOU Chu-yao;  SUN Ling-ling;  HUANG Ya;  DING Yuan;  WANG Qin
(Department of Critical Care Medicine)
关键词:
血栓弹力图;  凝血试验;  凝血功能;  肝移植术
Keywords:
thromboelastography;  coagulation function tests;  coagulation function;  liver transplantation
分类号:
R446.11
DOI:
10.3969/j.issn.1672-271X.2019.04.010
文献标志码:
A
摘要:
目的 探讨肝移植术后患者血栓弹力图(TEG)与凝血试验各指标的相关性，评价2种方法在肝移植围术期的应用价值，为临床监测肝移植术后患者凝血功能变化提供一定的指导。 方法 回顾性分析2016年5月至2018年5月南京中医药大学附属八一医院择期或急诊行肝移植术47例患者的临床资料，所有患者于手术结束后转入ICU并在30 min内完成血液标本采集，在2 h内完成TEG、常规凝血试验和血小板(PLT)计数检测。分析患者TEG检测中反应时间（R值）、血块形成速率参数（K 值）、最大切角（α角）、最大振幅（MA值）与凝血试验中凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)及PLT之间的相关关系。 结果 ①R值与APTT显著相关（P=0.010）；K值与APTT、PLT显著相关（P=0.020，0.012）；α角与APTT、PLT、MA值显著相关（P=0.002，0.004，0.014）；R值、MA值、K值、α角任意两者之间相关（P<0.05）；②R值与APTT呈线性相关（P=0.001）；MA与FIB、PLT呈线性相关（P=0.006，0.013）；MA与K、α角呈线性相关（P=0.008，0.000）。 结论 肝移植术后患者的TEG指标与常规凝血试验检测指标存在明显相关，两者在肝移植患者术后凝血功能监测中都具有重要作用。
Abstract:
Objective To evaluate the clinical values of thromboelastography and coagulation function tests applied in the perioperative period of liver transplantation by investigating the correlation of parameters of the above methods and further provide some guidelines for monitoring the changes of coagulation function of patients after receiving liver transplantation. Methods We retrieved the datum of the patients who underwent emergency or selective liver transplantation in our hospital. All patients were transferred to ICU after surgery. Blood sample were collected within 30 minutes and TEG tests were conducted，routine coagulation test and platelet count (PLT) in 2 hours. We analyzed the correlation between the parameters of TEG and routine coagulation test and platelet count. Results ①According to the results of correlation analysis，R value was significantly correlated with APTT（P=0.010）. K value was significantly correlated with APTT and PLT（P=0.020，0.012）. Angle was significantly correlated with APTT，MA and PLT（P=0.002，0.004，0.014）. Each of them was correlated in R value，MA，K value and Angle (P<0.05). ②R value and APTT showed a linear relation (P=0.001). MA and FIB，PLT showed a linear relation respectively(P=0.006，0.013). MA and K value，Angle showed a linear relation respectively (P=0.008，0.000). Conclusion There is a significant correlation between TEG and coagulation test after liver transplantation. Both of them play an important role in monitoring patients’ coagulation function during perioperative period.

参考文献/References:

1 Johansson PI，SolbeckS，GenetG，et al.Coagulopathy and hemostatic monitoring in cardiac surgery：an update[J].Scand Cardiovasc J，2012，46(4)：194-202．
2 任秀昀，高农，刘卫星.超声造影对肝移植术后并发症诊断的应用[J].武警医学，2015，26(2)：205-208.
3 GallLS，DavenportRA.Fibrinolysis and antifibrinolytic treatment in the trauma patient[J].Curr Opin Anaesthesiol，2018，31(2)：227-233.
4 RizoliS，MinA，SanchezAP，et a1.In trauma，conventional ROTEM and TEG results are not interchangeable but are similar in clinical applicability[J].Mil Med，2016，181(5Suppl)：117-126.
5 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.
6 杨婉薇，姚孝明，施建丰，等.血栓弹力图与常规凝血试验评价凝血功能的相关性分析[J].江苏医药，2015，41(7)：805-807.
7 KaronBS.Why is everyone so excited about thromboelas-trography(TEG)[J].Clin Chim Acta，2014，436(3/4)：143-148.
8 GallLS，BrohiK，DavenportRA.Diagnosis and Treatment of Hyperfibrinolysis in Trauma(A European Perspective)[J].Semin Thromb Hemost，2017，43(2)：224-234.
9 冯筑生，李俊杰，尹文.血栓弹力图在创伤领域的应用进展[J].中华急诊医学杂志，2016，25(5)：563-567.
10 LeeperCM，KutcherM，NasrI，et al.Acute traumatic coagulopathy in a critically injured pediatric population：Definition，trend over time，and outcomes[J].J Trauma Acute Care Surg，2016，81(1)：34-41.
11 NagI，DattaSS，DeD，et a1.Role of thmmboelastography in the management of snake bite：A ease report from India[J].Transfus Apher Sci，2017，56(2)：127-129.
12 LiuC，GuanZ，XuQ，et a1.Relation of thromboelastogTaphy parameters to conventional coagulation tests used to evaluate the hypercoagulable state of aged fracture patients[J].Medicine(Baltimore)，2016，95(24)：e3934.
13 卢尧，滕方，孙桂香，等.肝硬化患者凝血障碍机制研究进展[J].中国输血杂志，2015，28(2)：216-220.
14 陈冠伊，欧阳锡林，吴靖辉，等.血栓弹力图与常规凝血四项评价临床患者凝血功能的对比研究[J].中国实验血液学杂志，2015，23(2)：546-551.
15 王希龙，赵玲芳，刘建军，等.血栓弹力图联合凝血指标对早期急性胰腺炎严重程度评估的临床意义[J].东南国防医药，2017，19(2):141-144.
16 董林剑，李元海.血栓弹力图的临床应用及发展[J].安徽医药，2015，19(5):817-820.
17 王斌，王绍显，周春，等.血栓弹力图对预测颅内动脉瘤支架辅助栓塞术血栓相关并发症的作用[J].医学研究生学报，2018，31(3)：254-257.

相似文献/References:

[1]王希龙,赵玲芳,刘建军,等.血栓弹力图联合凝血指标对早期急性胰腺炎严重程度评估的临床意义[J].医学研究与战创伤救治(原医学研究生学报),2017,19(02):141.[doi:10.3969/j.issn.1672-271X.2017.02.007]
　WANG Xi-long,ZHAO Ling-fang,LIU Jian-jun,et al.Clinical significance of TEG combined coagulation testsin evaluating severity of illness in early acute pancreatitis[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2017,19(4):141.[doi:10.3969/j.issn.1672-271X.2017.02.007]
[2]曾庆波,宋景春,林青伟,等.创伤合并弥散性血管内凝血患者血栓弹力图诊断标准的临床研究[J].医学研究与战创伤救治(原医学研究生学报),2018,20(05):471.[doi:10.3969/j.issn.1672-271X.2018.05.005]
　ZENG Qing-bo,SONG Jing-chun,LIN Qing-wei,et al.Clinical study on the diagnostic value of maximum amplitude for the heatstroke with DIC[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2018,20(4):471.[doi:10.3969/j.issn.1672-271X.2018.05.005]
[3]宋景春,胡炜,杨洋,等.应用血栓弹力图评价乌司他丁的体外抗凝作用[J].医学研究与战创伤救治(原医学研究生学报),2018,20(05):480.[doi:10.3969/j.issn.1672-271X.2018.05.007]
　SONG Jing-chun,HU Wei,YANG Yang,et al.Effects of ulinastatin on coagulation in vitro in Chinese healthy volunteers[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2018,20(4):480.[doi:10.3969/j.issn.1672-271X.2018.05.007]
[4]洪二春,戴李华,王海嵘,等.凝血功能及血栓弹力图在急性缺血性脑卒中静脉溶栓预后中的预警作用[J].医学研究与战创伤救治(原医学研究生学报),2018,20(05):485.[doi:10.3969/j.issn.1672-271X.2018.05.008]
　HONG Er-chun,DAI Li-hua,WANG Hai-rong,et al.The predictive effect of coagulation function and thromboelastography on the prognosis of acute thrombolysis in acute ischemic stroke[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2018,20(4):485.[doi:10.3969/j.issn.1672-271X.2018.05.008]
[5]钟林翠,宋景春,姜峻,等.血小板聚集率在评价脓毒症患者血小板功能及预后中的价值[J].医学研究与战创伤救治(原医学研究生学报),2020,22(3):249.[doi:10.3969/j.issn.1672-271X.2020.03.006]
　ZHONG Lin-cui,SONG Jing-chun,JIANG Jun,et al.Clinical study on platelet aggregation to evaluate platelet function and prognosis in patients with sepsis[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2020,22(4):249.[doi:10.3969/j.issn.1672-271X.2020.03.006]
[6]曾庆波,宋景春,钟林翠,等.严重创伤与脓毒症患者凝血功能紊乱的比较研究[J].医学研究与战创伤救治(原医学研究生学报),2020,22(4):367.[doi:10.3969/j.issn.1672-271X.2020.04.007]
　ZENG Qing-bo,SONG Jing-chun,ZHONG Lin-cui,et al.Comparation of coagulation dysfunction between severe trauma and sepsis patients[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2020,22(4):367.[doi:10.3969/j.issn.1672-271X.2020.04.007]
[7]胡艳晶,宋景春,李单,等.大黄治疗脓毒症性凝血病的单中心回顾性病例对照研究[J].医学研究与战创伤救治(原医学研究生学报),2022,24(1):13.[doi:10.3969/j.issn.1672-271X.2022.01.003]
　HU Yan-jing,SONG Jing-chun,LI Dan,et al.Effect of rhubarb in the treatment of sepsis-induced coagulopathy: A single-center retrospective case-control study[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(4):13.[doi:10.3969/j.issn.1672-271X.2022.01.003]
[8]雷文婧,朱敏,吴迪,等.阿司匹林与氯吡格雷联合疏血通注射液对缺血性脑卒中患者的凝血功能改善评价[J].医学研究与战创伤救治(原医学研究生学报),2022,24(6):569.[doi:10.3969/j.issn.1672-271X.2022.06.002]
　LEI Wen-jing,ZHU Min,WU Di,et al.Evaluation of improved coagulation function in patients with ischemic stroke with aspirin and clopidogrel combined with Shuxuetong injection[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(4):569.[doi:10.3969/j.issn.1672-271X.2022.06.002]

备注/Memo

备注/Memo:
收稿日期：2018-11-18
更新日期/Last Update: 2019-07-11