[1]宋晓阳　黎笔熙　陈　敏　甘国胜　秦明哲　程鹏飞　陶　军　周　翔.血栓弹力图在重型颅脑损伤患者围手术期的应用[J].中国临床神经外科杂志,2016,(01):17-19.[doi:10.13798/j.issn.1009-153X.2016.01.006]
　SONG Xiao-Yang,LI Bi-Xi,CHEN Min,et al.Application of thrombelastography to guiding perioperative treatment of patients with severe traumatic brain injury[J].,2016,(01):17-19.[doi:10.13798/j.issn.1009-153X.2016.01.006]
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血栓弹力图在重型颅脑损伤患者围手术期的应用()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年01期
页码:
17-19
栏目:
论著
出版日期:
2016-01-25

文章信息/Info

Title:
Application of thrombelastography to guiding perioperative treatment of patients with severe traumatic brain injury
文章编号:
1009-153X（2016）01-0017-03
作者:
宋晓阳　黎笔熙　陈　敏　甘国胜　秦明哲　程鹏飞　陶　军　周　翔
430070 武汉，广州军区武汉总医院麻醉科
通讯作者：周　翔，E-mail：zhouxiang188483@126.com
Author(s):
SONG Xiao-Yang;  LI Bi-Xi;  CHEN Min;  GAN Guo-Shen;  QIN Ming-Zhe;  CHEN Peng-Fei;  TAO Jun;  ZHOU Xiang.
Department of Anesthesiology, Wuhan General Hospital, Guangzhou Command, PLA, Wuhan 430070, China
关键词:
重型颅脑损伤; 围手术期; 血栓弹力图; 凝血功能
Keywords:
Thrombelastography;  Coagulation function;  Perioperative treatment;  Traumatic brain injury
分类号:
R 651.1+5; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2016.01.006
文献标志码:
A
摘要:
目的 探讨血栓弹力图（TEG）在重型颅脑损伤患者围手术期的应用价值。方法 2014年10月1日~2015年8月1日急诊开颅血肿清除术治疗重症颅脑损伤患者78例，根据围手术期凝血功能监测方法分为TEG组（n=39）和经验治疗组（n=39）。TEG组测量反应时间（R值）、凝血形成时间（K值）、血栓最大幅度（Ma值）和凝固角（α值）等项参数，根据测量结果输注血液制品。经验治疗组则根据出血量及血气分析结果，按照经验疗法进行围手术期管理。结果 两组患者的手术时间无显著差异（P>0.05）；TEG组的出血量以及红细胞、新鲜冰冻血浆、冷沉淀、血小板输注量均较经验治疗组明显减少（P<0.01）；术后6、24 h引流量，teg组较经验治疗组均显著下降（P<0.01）；两组二次开颅手术率和30 d死亡率无明显差异（P>0.05）。结论 TEG可监测凝血功能，指导输血，减少血液制品输注量，减少术后颅内出血发生几率，在重型颅脑损伤患者围手术期具有重要的意义。
Abstract:
Objective To investigate the value of thrombelastography (TEG) to perioperative treatment in patients with severe traumatic brain injury (TBI). Methods Seventy-eight patients with TBI were divided into TEG group (n=39) and control group (n=39). TEG tests were performed at different perioperative stages and different kinds of blood products including plasma, platelets and so on were intravenously infused according to the TEG Results in the TEG group. The blood products were perioperatively infused according to the traditional experiential therapy in the control group. The operative duration, volumes of bleeding, blood products transfusion, and drainage 6 and 24 hours after the operation, and cases of unplanned second operation were compared between both the groups. Results There was no difference in the operation duration between both the groups. The volumes of bleeding, blood products transfusion and drainage 6 and 24 hours after the operation were significantly more in the control group than those in the TGE group (P<0.01). there="" were="" 2="" patients="" undergoing="" unplanned="" second="" operations="" in="" the="" control="" group="" and="" was="" no="" patient="" operation="" teg="" group.="">Conclusions The coagulation function can be monitored and the volumes of the bleeding and blood products transfusion can decreased by TEG, and therefore it is of important value to the perioperative treatment in the patients with TBI.

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更新日期/Last Update: 2016-01-30