摘要
目的评价血栓弹力图(TEG)在小儿先天性心脏病(先心病)体外循环围术期的应用价值。方法 81例先心病患儿分别于转流前、转流毕、术后早期进行TEG检测,收集的病例分为紫绀组(12例)和非紫绀组(69例),比较围术期各个时间点凝血功能变化。结果两组TEG各参数结果比较无统计学意义。紫绀组转流前纤维蛋白原缺乏发生率高于非紫绀组(P<0.05),紫绀组转流毕及术后早期纤维蛋白原水平较非紫绀组低下(P<0.05),且CPB时间长,术后4 h引流量多,术后24 h血浆用量高于非紫绀组(P<0.05)。结论先心病患儿围术期存在较高比例凝血功能异常;紫绀患者纤维蛋白原低下发生率高,应给予针对性血液成分补充;TEG对分析先心病患儿术后异常出血原因及指导合理使用血制品具有重要价值。
Objective To analyze the usefulness of thromboelastography （TEG） in children undergoing cardiac surgery with cardiopulmonary bypass （CPB）. Methods 81 pediatric patients who underwent cardiac surgery with CPB received TEG measurement periopemtively. They were analyzed and divided into cyanotic group （n = 12） and acyanotic group （n =69）. All TEG results, excessive blood loss after cardiac surgery, iribrinogen leveif, and platelet counts were recorded. Restflts There were no differences of TEG results between cyanotic group and acyanotic group. Pre - bypass, according to TEG, the fibrinogen dysfunction occurrence of cyanotic group was higher than acyanotic group （ P 〈0.01 ）. Compared to acyanotic group, cyanotic group had lower fibrinogen level off - bypass and post -operation （ P 〈 0. 05 ）. Cyanotic group had longer CPB time, more chest tube drainage volume and more fresh frozen plasma usage. Conclusion Pediatric patients underwent cardiac surgery with CPB are more likely to suffer from coagulopathies perioperatively. Cyanotic patients have high occurrence of low fthrinogen. This study showed that TEG test is helpful for diagnosing and curing excessive bleeding patients after cardiac surgery with CPB in children.
出处
《中国体外循环杂志》
2013年第1期11-14,共4页
Chinese Journal of Extracorporeal Circulation
基金
浙江省重点科技创新团队-儿童出生缺陷早期筛查与干预技术科技创新团队(2010R50045)
中央高校基本科研业务费专项资金资助(2011KYJD008
2012QNA7041)
浙江省医药卫生平台重点资助项目(2012ZDA030
2012ZDA031)
关键词
血栓弹力图
体外循环
凝血功能
血小板功能异常
Thromboelastography
Cardiopulmonary bypass
Coagulation
Platelet disorder
