血栓弹力图指导肝癌患者围手术期临床输血的应用分析

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1、结果两组肝癌患者临床输注不同血液制品后，和输注血液前相比，两组肝癌患者的PT、APTT和TT数值均有显著性缩短，PLT和FIB数值显著性增加，差异有统计学意义(P<0.01)；和对照组相比，实验组肝癌患者输血后的凝血功能异常改善状况明显优于对照组，PT、APTT、TT明显缩短，出血及渗血量、悬浮红细胞及冰冻血浆使用量明显减少，冷沉淀凝血因子使用量有所增加，出血及渗血时间明显缩短，差异有统计学意义(P<0.05),PLT和FIB数值增加不明显,血小板使用量基本持平，差异无统计学意义(P>0.05)。TEG检测结果发现：实验组肝癌患者中有11例凝血因子活性较

2、高，有35例纤维蛋口原活性差，有18例血小板功能较强，有2例患者纤溶亢进，分别占实验组人数的26.83%、85.37%、43.90%和4.88%。结论1•使用不同的血液制品可以较好地纠正肝癌患者围手术期凝血功能异常伴出血状况。2.TEG比普通凝血检测更加准确地评估肝癌患者的凝血功能异常状况及出血原因。3.TEG比普通凝血检测指导围手术期凝血功能异常伴出血肝癌患者的临床输血更加科学有效。4.TEG指导临床输血可较好地降低肝癌患者围手术期间临床输血量、出血和渗血量及出血时间。关键词：血栓弹力图；肝癌患者；围手术期;StudyoftheApplicationo

3、fThromboelastographyGuidedClinicalTransfusionofPatientswithLiveCancerduringPerioperativePeriodPostrgraduate:ShujunShaoSupervisor:Prof.HaiboWengLifeSciencesCollegeofZhengzhouUniversityZhengzhou,450008AbstractObjectiveTheaimofthisstudyistoinvestigatetheapplicationofindependentlyoru

4、nitedutilizationofplateletcell,frozenplasma,andcryoprecipitateinpatientswith1ivecancerwhohaveabnormalbloodagglutinateduringperioperativeperiod.Byobservingtheeffectsontheimprovementofabnormalbloodagglutinateconditionsoflivecancerpaticntsaftertransfusionofdiffcrcntbloodcomponents，

5、thisstudyaimstoexploreascientificandeffectiveclinicaltransfusionmethoc!forlivecancerpatients(LCP)withabnormalbloodagglutinateduringperioperativeperiodwhichcanreducethetimeandamountofLCPs，perioperativehaemorrhage,staxisemdbloodtransfusion.ThestudyalsoaimstoimprovethetreatmentofLCP

6、s,andtoscientifically,rationally,andeffectivelytransfusedifferentbloodproducts.Method82casesoflivecancerpatientswhohaveabnormdlbloodagglutinateandhaemorrhageafterlivecancersurgerywereselectedforthisstudy.Thesepatientswereadmittedinahepatobiliarysurgerydepartmentinaprovincialtert

7、iaryleveltumorhospitalinHenanprovincefromJanuary2012toDecember2014.Theywererandomlydividedintotwogroups:conventionalcoagulationdetectionguidedtnmsfusionofbloodcomponents(controlgroup)andTEGguidedtransfusionofbloodcomponentsgroup(experimentalgroup),eachgroupconsistsof41LCPpatient

8、s>Eachgrouphasbeengivenroutinetreatmenta