|
|
|
| Evaluation on the Application of TEG in Blood Transfusion in Patients with Traumatic Hemorrhagic Shock |
| DAI Si-yuan, GU Lan |
| Departmentof Blood Transfusion, The Third Xiangya Hospital of Central South University, Changsha, 410013 |
|
|
|
|
Abstract 【Objective】To explore the significance of thromboelastography (TEG) in blood transfusion of patients with traumatic hemorrhagic shock.【Methods】A total of 104 Patients with traumatic hemorrhagic shock treated in our hospital from January 2018 to December 2020 were selected. Among them, 52 cases in the control group did not undergo TEG examination before receiving blood transfusion, while 52 cases in the observation group received blood transfusion under the guidance of TEG. The coagulation function tests such as activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and fibrinogen (FIB), the TEG test results ( R value, K value, α angle and MA value) before and after blood transfusion, the amount of blood component infusion and the prognosis of the two groups were compared.【Results】The levels of APTT, PT, TT after blood transfusion in the two groups were lower than that before blood transfusion (P<0.05), while the FIB level was higher (P<0.05). After blood transfusion, the levels of APTT, PT, and TT in the observation group were lower than those in the control group (P<0.05), and the FIB level in the observation group was higher than that in the control group (P<0.05). In the observation group, the R value and K value after blood transfusion were lower than before (P<0.05), and α angle and MA value were increased (P<0.05). The amount of RBCs and plasma in the observation group was lower than that of the control group, while the amount of cryoprecipitate and platelets was higher than that in the control group (P<0.05).【Conclusion】TEG can provide a reasonable strategy for blood transfusion in patients with traumatic hemorrhagic shock by improving blood coagulation function more effectively, which has great clinical value.
|
|
Received: 19 May 2021
|
|
|
|
|
|
[1] FLOCCARD B,RUGERI L,FAURE A,et al. Early coagulopathy in trauma patients: an on-scene and hospital admission study[J].Injury,2012,43(1): 26-32.
[2] NAKAJIMA T, KATO H, MATHIS B J, et al. TEG improves anticoagulation management during cardiopulmonary bypass complicated by antiphospholipid syndrome[J].J Card Surg,2020, 35(6): 1354-1356.
[3] THAI C, OBEN C, WAGENER G, et al. Coagulation, hemostasis, and transfusion during liver transplantation[J].Best Pract Res Clin Anaesthesiol,2020, 34(1): 79-87.
[4] KOPYTEK M. Effects of direct oral anticoagulants on thromboelastographic parameters and fibrin clot properties in patients with venous thromboembolism[J].J Physiol Pharmacol,2019, 71(1): 47-53.
[5] 伍陈海,谢海,陈勇.血栓弹力图指导合理输血的有效性及对患者结局的影响Meta分析[J].临床麻醉学,2014,30(4):321-326.
[6] 张连阳, 李阳. 创伤失血性休克进展[J] .临床急诊杂志 2018, 19(3):145-148.
[7] GBD 2013 Mortality and Causes of Death Collaborators. Global,regional,and national age-sex specific all-cause and cause- specific mortality for 240 causes of death,1990－2013: a systematic analysis for the Global Burden of Disease Study 2013 [J].Lancet,2015, 385(9963) : 117.
[8] 张楠,屈跃军,白振宇.创伤性失血患者大量输血前后凝血功能与血液指标变化分析[J].医药论坛, 2016,11(10):55-57.
[9] PEKELHARING J,FURCK A,BANYA W,et al. Comparison between thromboelastography and conventional coagulation tests after cardiopulmonary bypass surgery in the paediatric intensive care unit[J].Int J Lab Hematol,2014,36(4):465-471.
[10] 候涛, 赵广超, 邵小宝, 等. 血栓弹力图与常规凝血试验指导临床输血的对比[J].临床检验杂志,2016,34(10): 739-741.
[11] CANTLE P M,COTTON B A.Balanced resuscitation in trauma management[J].Surg Clin North Am,2017, 97(5):999-1014.
[12] 高叶,张璐平,殷辰俞,朱涛.探讨血栓弹力图在创伤性休克患者早期诊断凝血功能变化中的应用价值[J].世界复合医学,2021,7(1):98-100.
[13] 江光荣,周炜,邬俊勇.血栓弹力图对严重创伤后出血患者输血治疗的指导价值[J].当代医学,2021,27(21):168-170. |
|
|
|
2021, Vol. 38 
