摘要
目的比较传统凝血试验(conventional coagulation test,CCT)和血栓弹力图分析仪(thromboelastography,TEG)在诊断腹部创伤患者凝血功能障碍的价值。方法选择2017年1月至2018年1月东南大学医学院附属江阴市人民医院普通外科收治的38例以腹部创伤为主患者同时进行CCT与TEG监测,比较两种检测方法诊断凝血功能障碍的敏感性与特异性;并对发现创伤后早期(≤6 h)患者亚组进行比较分析。结果腹部创伤患者凝血功能障碍CCT阳性率(8例,21.1%)明显低于TEG(阳性21,55.2%,P<0.05);创伤后早期凝血功能障碍CCT阳性率(3/13,23.1%)亦明显低于TEG(9/13,69.2%,P<0.05)。结论 TEG诊断创伤后凝血功能障碍的敏感性与特异性明显优于CCT方法,特别是对于创伤后早期凝血功能障碍的诊断TEG更具有优势。
Objective To compare the clinical usage of TEG（ thromboelastography,TEG） and（conventional coagulation tests,CCT） in diagnosing trauma-induced coagulopathy. Methods The clinical data of 38 patients with abdominal trauma,from January 2017 to January 2018,were prospectively reviewed.Both of thromboelastography（ TEG） and CCT were immediately performed at the patients＇ arrival. Data were analyzed to compare the differences of sensitivity of the two test methods in finding TIC of all trauma patients and only in the patients who got hurt within 6 hours,and the correlation of two methods with the ISS.All data were analyzed by using chi-square test,t-test,Fisher exact test and Spearman rank analysis.Results The CCT results of 8（ 21. 1%） patients were positive,and the TEG results of 21（ 55. 2%）patients were positive. Furthermore,there was 1 patient showing negative in the TEG among the 8 patients whose CCT results were positive,while 14 patients showing negative in the CCT among the 21 patients whose TEG results were positive. The significant difference between the two groups（ P = 0. 037） can be noticed.There were 13 patients admitted to hospital within 6 hours,among whom 3（23. 1%） patients were positive in CCT and 9（69. 2%） patients were positive in TEG. All the 3 patients with positive CCT results were also positive in TEG,and the 6 patients with positive TEG results were negative in CCT. There was significant difference between the two different groups（ P = 0. 028） as well. R value in TEG test was related to ISS,and PT,APTT,K value were not related to ISS. Conclusion Based on our preliminary results,TEG was better than CCT in diagnosing TIC（ trauma-induced coagulopathy） and ATC（ Acute Traumatic Coagulopathy）,with higher positive rates and better sensitivity.
作者
周一夫
赵振国
刘双海
Zhou Yifu;Zhao Zhenguo;Liu Shuanghai(Department of general surgery,Jiangyin people＇s Hospital Affiliated to Medical College of Southeast University,Jiangyin 214400,China)
出处
《中华卫生应急电子杂志》
2018年第3期157-161,共5页
Chinese Journal of Hygiene Rescue(Electronic Edition)
关键词
创伤后凝血功能障碍
传统凝血试验
血栓弹力图检测
创伤严重程度评分
Trauma-Induced Coagulopathy（TIC）
Conventional Coagulation Testing（CCT）
thrombelastogram（TEG）
injury severity score（ISS）
