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目的探讨血栓弹力图(TEG)在指导产后出血患者合理输血中的应用价值。方法48例产后出血产妇随机均分为两组,在胎儿娩出20min内抽取产妇静脉血,试验组检测TEG数据包括凝血反应时间、凝血形成时间、凝固角、最大血块强度(MA)和MA确定后30min血凝块幅度减少速率,对照组检测常规凝血数据包括凝血酶原时间、活化部分凝血活酶时间、国际标准化比值、纤维蛋白酶原和血小板计数。两组分别根据TEG和常规凝血数据指导临床输血。结果试验组输血率以及血浆[(260±68)ml vs.(680±266)ml]、血小板[(0.79±0.26)U vs.(1.26±0.49)U]、冷沉淀[(0.62±0.19)U vs.(0.89±0.35)U]的使用量均低于对照组(P均<0.05)。结论 TEG能更高效合理地指导产后出血患者血制品的输注,在保证治疗效果的前提下减少输血率和血制品的滥用,是围产期较为理想的输血指导方法。
Objective To investigate the value of thrombus elastography (TEG) in guiding rational blood transfusion in patients with postpartum hemorrhage. Methods 48 cases of postpartum hemorrhage were randomly divided into two groups. The maternal venous blood was taken within 20 minutes after the fetus was delivered. The data of TEG in the test group including the clotting reaction time, coagulation time, the coagulation angle, the maximum clot strength (MA) 30min reduction rate of clot amplitude, the control group to detect routine coagulation data including prothrombin time, activated partial thromboplastin time, the international standardization ratio, fibrinogen and platelet count. Two groups according to TEG and routine coagulation data to guide clinical blood transfusion. Results The blood transfusion rate in the test group was significantly higher than that in the control group ([(260 ± 68) ml vs. (680 ± 266) ml], platelet [(0.79 ± 0.26) U vs. (1.26 ± 0.49) U vs. (0.89 ± 0.35) U] was lower than that of the control group (all P <0.05). Conclusion TEG can guide the infusion of blood products in patients with postpartum hemorrhage more efficiently and rationally. It is an ideal method of blood transfusion during perinatal period to reduce the transfusion rate and the abuse of blood products under the premise of ensuring the therapeutic effect.