摘要
目的探讨血栓弹力图(TEG)在高龄孕产妇妊娠期的运用价值,为高龄孕产妇凝血功能监测及相关防治措施制定提供参考。方法选择佛山市第一人民医院2016年1月-2017年1月就诊的年龄≥35岁(高龄)孕产妇130例(观察组)、年龄<35岁孕产妇150例(对照组),测定各组不同妊娠期凝血功能4项指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及纤维蛋白原(FIB)]及TEG指标[反应时间(R)、凝血时间(K)、α角、最大振幅(MA)、凝血指数(CI)]。结果观察组年龄显著大于对照组,差异有统计学意义(P<0. 05),而生产史、流产次数、产前检查次数比较两组差异均无统计学意义(均P>0. 05)。凝血4项指标:两组妊娠12周内、30~34周、37~42周PT、APTT、TT、FIB水平比较差异均无统计学意义(均P>0. 05)。TEG监测:观察组妊娠12周内、30~34周、37~42周α角分别为(67. 12±3. 48)°、(70. 25±3. 50)°、(71. 12±3. 53)°,均显著高于对照组的(66. 30±2. 52)°、(68. 53±3. 32)°、(69. 41±3. 48)°,差异有统计学意义(P<0. 05);观察组妊娠30~34周、37~42周MA值分别为(68. 47±2. 63) mm、(69. 52±3. 43) mm,均显著高于对照组的(66. 54±2. 56) mm、(67. 18±3. 25) mm,差异有统计学意义(P<0. 05);其他指标两组不同妊娠期比较差异均无统计学意义(均P>0. 05)。结论高龄孕产妇进行TEG监测能准确显示机体凝血状态,以α角、MA为主要参数。
Objective To discuss the value of thrombelastogram( TEG) in gestation period of elderly pregnant and lying-in women. Methods One hundred and thirty pregnant and lying-in women ≥ 35 years old( older pregnancy group) who were admitted to the hospital from January 2016 to January 2017 and 150 pregnant women <35 years old( non-older pregnancy group) were enrolled in the study. The four blood coagulation indexes [prothrombin time( PT),activated partial thromboplastin time( APTT),thrombin time( TT) and fibrinogen( FIB) ] and TEG indexes [reaction time( R),clotting time( K),α angle,maximum amplitude( MA),coagulation index( CI) ]in each group were determined at different time. Results The age of the older pregnancy group was significantly larger than that of the non-older pregnancy group( P<0. 05),but there was no significant difference in the delivery history,times of abortions or times of prenatal examinations between the two groups( P>0. 05). There was no significant difference in the levels of PT,APTT,TT and FIB between the two groups within 12 weeks,30 to 34 weeks or 37 to 42 weeks of pregnancy( P>0. 05). TEG monitoring showed that the α angles in the older pregnancy group within 12 weeks,30 to 34 weeks and 37 to 42 weeks of pregnancy [( 67. 12±3. 48) °,( 70. 25±3. 50) ° and( 71. 12±3. 53) °] were significantly larger than those in the non-older pregnancy group [( 66. 30±2. 52) °,( 68. 53±3. 32) ° and( 69. 41±3. 48) °]( P<0. 05). The MA values of the older pregnancy group within 30 to 34 weeks and 37 to 42 weeks of pregnancy [( 68. 47±2. 63) mm and( 69. 52± 3. 43) mm] were significantly larger than those in the non-older pregnancy group [( 66. 54 ± 2. 56) mm and( 67. 18 ±3. 25) mm]( P<0. 05). There was no significant difference between the two groups in the other indicators during different periods of pregnancy( P> 0. 05). Conclusion The TEG monitoring of elderly pregnant women can accurately show the coagulation status. The main parameters are α angle and MA.
作者
卢文琼
陈小宁
廖珊
LU Wen-Qiong;CHEN Xiao-Ning;LIAO Shan(Fo shan Frist Peopled Hospital,Foshan,Guangdong 528000,China)
出处
《中国妇幼保健》
CAS
2019年第13期2969-2972,共4页
Maternal and Child Health Care of China
关键词
血栓弹力图
高龄孕产妇
妊娠期
凝血功能
Thrombelastogram
Elderly pregnant and lying-in women
Gestational period
Coagulation function
