血栓弹力图和常规凝血功能指标对危重新生儿凝血功能异常的诊断效能及其意义

doi:10.3969/j.issn.1671-7171.2021.03.028

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Abstract 【Objective】To investigate the diagnostic efficacy and significance of thromboelastography (TEG) and routine coagulation function indexes in the diagnosis of coagulation dysfunction in critically ill neonates. 【Methods】The clinical data of 160 cases of critical rebirth in Henan Provincial People's Hospital from August 2016 to April 2019 were retrospectively analyzed. According to the results of routine coagulation function examination, the patients were divided into abnormal coagulation function group (observation group, n =90) and normal coagulation function group (control group, n =70).TEG was performed in both groups.The results of routine coagulation function examination and TEG parameters were compared between the two groups. The changes of TEG parameters of children with different conditions in the observation group were analyzed. Pearson method was used to analyze the correlation of each index, and receiver operating characteristic curve (ROC) was drawn to evaluate the diagnostic value of each index for critically ill newborns.【Results】PT, APTT and TT in the observation group were significantly longer than those in the normal group ( P <0.05), R value and K value in TEG were significantly shorter than those in the control group; α angle, EPL and LY30 in the observation group were higher than those in the control group ( P <0.05), and there was no significant difference in FIB and MA between the two groups ( P >0.05). The PT and APTT of most critically ill children were significantly longer than those of critically ill children ( P <0.05), the R and K values were shorter than those of critically ill children, and the LY30 value was higher than that of critically ill children ( P <0.05).Pearson correlation analysis showed that R value was negatively correlated with PT and APTT, but not with TT. K value was negatively correlated with APTT ( P <0.05). EPL and LY30 were well correlated with PT and APTT ( P <0.05). ROC curve showed that APTT had the highest area under the curve in conventional coagulation indexes, and R value and LY30 had higher area under the curve in TEG parameters. Except K value, the area under the curve of other TEG parameters were higher than that of conventional coagulation function indexes. The overall diagnostic efficiency of TEG was higher than that of conventional coagulation function examination.【Conclusion】Compared with routine coagulation function test, TEG has higher value in the diagnosis of coagulation dysfunction in critically ill neonates, and the parameters of TEG are closely related, so it can be used as an auxiliary examination method.

Key words： Infant Newborn Diseases Critical Illness Blood Coagulation/DI Thrombelastography

Received: 29 August 2019

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R722.1

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2021.03.028 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2021/V38/I3/416

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