1000ml 的58例患者為研究對象,按隨機(jī)投擲法分為參照組和研究組,每組29例。參照組基于常規(guī)輸血共識(shí)確定輸血方案,研究組基于血栓彈力圖指導(dǎo)實(shí)施大量輸血方案。比較兩組血制品各成分(機(jī)采血小板、新鮮冰凍血漿、去白細(xì)胞懸浮、冷沉淀凝血因子)用量、血小板計(jì)數(shù)(PLT)、凝血指標(biāo)[凝血酶原時(shí)間(PT)凝血酶時(shí)間(TT)、活化部分凝血活酶時(shí)間(APTT)、纖維蛋白原(FIB)]水平、再出血發(fā)生情況、血栓彈力圖(TEG)試驗(yàn)指標(biāo)[凝血時(shí)間(R)、血塊形成速率(K和Angle)、總體凝血指數(shù)(CI)、最大血塊強(qiáng)度(MA)血塊穩(wěn)定性(LY30與EPL)]。結(jié)果 研究組機(jī)采血小板、新鮮冰凍血漿、去白細(xì)胞懸浮、冷沉淀凝血因子用量均低于參照組 (P<0.05) ;輸血后,研究組PT、TT、APTT短于參照組,而FIB高于參照組( <sub>(P<0.05)</sub> ;兩組輸血后PLT比較,差異無統(tǒng)計(jì)學(xué)意義( (P>0.05) ;研究組再出血率為 3.45% ,參照組再出血率為 17.24% ,研究組再出血率低于參照組 (χ<sup>2</sup>=5.681,P=0.016) 。輸血后研究組 R,K,LY30,EPL 均低于參照組,而Angle 、MA,CI 均高于參照組(P<0.05) 。結(jié)論血栓彈力圖指導(dǎo)和大量輸血方案在圍手術(shù)期大量輸血中的應(yīng)用效果確切,能夠減少血制品各成分用量,促進(jìn)患者凝血功能指標(biāo)的改善,并能降低再出血率,值得臨床應(yīng)用。-龍?jiān)雌诳W(wǎng)" />

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血栓彈力圖指導(dǎo)和大量輸血方案在圍手術(shù)期大量輸血中的應(yīng)用

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中圖分類號(hào):R457.1 文獻(xiàn)標(biāo)識(shí)碼:A文章編號(hào):1006-1959(2025)12-0108-05

DOI:10.3969/j.issn.1006-1959.2025.12.022

Application of Thrombelastogram Guidanceand Massive Blood Transfusion Scheme inPerioperativeMassiveBloodTransfusion

ZHANG Renxiu, ZHANG Zihui, LI Yun,ZHAO Yandong,XIAO Mingliang,LYU Zhiying (DepartmentofloodTransfusion,XingguoountyPeople'sHospital,Xingguo3424o,Jiangxi,Cia)

Abstract:ObectieTploreteplcatioftofthobeastodaedasselodasfusioeiriopeatiasie blodtransfusioetsAotalof58atsodetscaltndtatedossfoovebl 2024inXingoutyeoplesospitalreeletedteachetsAccodingtoedthongetodteyeredite referencegroupandthestudygoup,with9patientsineachgroup.Thereferencegroupdeterminedtheblodtransfusionplanbasedonthe conventionalbloodtransfusionconsensusandtestudygoupimplementedalargenumberofbloodtransfusionplansasedontheuidanceof thromboelastogaefchotoflodpuctseesislateletsfreshrozlasmakotepleedsio cryoprecipiatdlaticors),ateaterot thromboplastinn),bdtelastaGstlatioi)otioate(le) overallcoagade(Ciotgth(Aotsabilt(dEL)oaredeteeooupsls amountofpisaodspopiaolo than that in thereference group( P< 0.05).Afterbloodtransfusion,PT,TTandAPTTinthestudygroupwereshorterthanthoseinthereferencegroup, while FIB was higher than that in the reference group( P<0.05 ,but there was no significant difference in PLTbetween thetwo groupsafter blood transfusion( P>0.05 ).Therebleeding rate of the study group was 3.45% ,and the rebleeding rate of the reference group was 17.24% ,thusthe rebleeding rate of the study group was lower than that of the reference group ( χ2 =5.681,P=O.O16).Afterblood transfusion,R,K,LY3O and EPL in the studygroupwerelowerthanthoseinthereferencegroup,whileAngle,MAandCIwerehigherthanthoseinthereferencegroup( P <0.05). ConclusionTelaotofelastodedmsselootrasuseioperaiesseodtasusiis definite,ichdeoefchmpotoflooductoteproetflatiofctioesofsd reduce the rate ofrebleeding.It is worthy of clinical application.

Keywords:Thrombelastogram;Mass transfusion programme;Perioperative period

輸血在臨床上屬于常見的治療與搶救方法,其能夠通過靜脈將血液輸注到患者體內(nèi),進(jìn)而保證患者健康安全。(剩余5850字)

目錄
monitor