实用妇产科杂志2018，Vol.34Issue(4)：277-281,5.
血栓弹力图用于剖宫产术中凝血监测及预测出血量的临床研究
Clinical Study on Monitoring Obstetric Hemorrhage and Predicting the Bleeding Risk by Use of Thrombelastography
摘要
Abstract
Objective:To evaluate the value of thrombelastography(TEG) in monitoring the coagulation function during perioperative period in patients with hemorrhagic disease of obstetrics,and to study whether TEG can predict the total blood loss intraoperation.Methods:From November 2015 to March 2016,30 maternals with placental abruption,placenta previa,placenta implantation or preeclampsia undergoing elective cesarean section as hemorrhage group(group H).30 normal maternals without aforementioned complications as the control group (group C).Monitoring the blood routine,coagulation,TEG intraoperative,determine whether TEG can predict the total blood loss in cesarean section perioperative period of maternal with obstetric hemorrhagic disease.Results:①There was no significant differences in maternal age between the two groups.Gestational age of group H was significantly less than the group C,the average total blood loss and the average transfusion of the group H were significantly higher than that in the group C.②In the group H,K value showed a positive correlation with hemoglobin (Hb) 、D-D,and a significant negative correlation with platelet(PLT) (r =-0.575,P =0.003);MA and CI also showed positive correlation with fibrinogen (Fig).In the group C,R value and K value were positively correlated with Hb but negatively correlated with PLT;MA、CI had obviously positive correlation with Fig,CI was also negatively correlated with Hb.③In the maternal with blood loss ＞ 1000 ml group,R value was significantly correlated with PT,K value was significantly correlated with PLT,PT and Fig.Angle and MA were significantly correlated with red blood cell count (RBC),Hb,hematocrit (HCT),PLT,PT,activated partial thromboplastin time (APT-T) and Fig.CI was negatively correlated with PT but positively correlated with Fig.④The TEG parameter K value,Angle,CI were correlated with the total blood loss,K value had the strongest correlation.⑤There was no significant difference in the TEG parameters between the massive bleeding group and the non-massive bleeding group.Conclusione:TEG parameters is proved to be associated with coagulation parameters,routine blood examination.The value of K,Angle and CI are related to the ammount of bleeding of maternal,which has hemorrhagic disease in cesarean section,but can't predict the risk of massive hemorrhage.关键词
血栓弹力图/产科出血性疾病/凝血功能/纤维蛋白原Key words
Thrombelastography/Hemorrhagic disease of obstetrics/Coagulation function/Fibrinogen分类
医药卫生引用本文复制引用
易宗平,高进,陈萍,余娅,王虹又,严艾,舒秋霞..血栓弹力图用于剖宫产术中凝血监测及预测出血量的临床研究[J].实用妇产科杂志,2018,34(4):277-281,5.基金项目
重庆市卫生计生委医学科研项目(编号:2015MSXM002) （编号:2015MSXM002）
