血栓弹力图在创伤性凝血病作用的临床研究.docVIP

精品论文 参考文献 血栓弹力图在创伤性凝血病作用的临床研究 李定武1 张智喜2 李峥嵘2 刘 东2 谢军朋2 赵连任2 华迎九2 陈金台2 　　（1.东莞光华医院 广东 东莞 523000） 　　（2.同济医学院附属东莞医院 广东 东莞 523000） 　　【摘 要】目的：探讨严重创伤的患者血栓弹力图（thrombelastogram， TEG）的变化。方法：对40例严重创伤患者随机分两组（A1及A2组）分别进行TEG 检测和常规凝血功能对比观察，A1组和一般创伤（B组）的患者进行TEG 对比观察。结果：A1组TEG的R值及K值缩短,A角、MA增大,与B组比较均差异有显著性(Plt;0.01), A1组在T0与T1、T2与T3时间段比较R值、ɑ角、MA、CI差异有显著性(Plt;0.05)，在T1与T2有明显差异(Plt;0.01)。A1组与B组各时间段诊断创伤性凝血病的例数有明显差异（Plt;0.01）。结论：TEG对创伤性凝血病具有早期诊断的价值，可较常规凝血功能检测提前3-5天得到精确数据，以便提前预防DIC的发生，减少MODS的出现，对提高严重创伤患者的治愈率有较大帮助。 　　【关键词】血栓弹力图；严重创伤；创伤性凝血病 　　【中图分类号】R641 【文献标识码】B 【文章编号】1003-5028（2015）6-0561-02 　　【Abstract】Objective：to patients with thromboelastography of severe trauma of the (Thrombelastogram, TEG) changes. Methods：40 cases of severe trauma patients were randomly divided into two groups (group A1 and A2 respectively) were observed and compared the detection of TEG and routine coagulation, A1 group and general trauma (group B) underwent TEG contrast observation. Results：in A1 group, the TEG R value and K value of A angle, shorten, the increase of MA, there was significant difference compared with B group (all Plt;0.01), group A1 was significant in comparison with T0 and T1, T2 and T3 time, R value, MA, alpha angle difference of CI (Plt;0.05), with significant difference in T1 and T2 (Plt;0.01). The number of cases of A1 group and B group each time the diagnosis of traumatic coagulopathy has significant difference (Plt;0.01),. Conclusion：TEG with early diagnosis of traumatic coagulopathy value, expected to be a routine coagulation test 3-5 days in advance to get accurate data, advance in order to prevent the occurrence of DIC, reduce the emergence of MODS, to improve the cure rate of the patients with severe trauma has a great help. 　　【Key words】thrombelastogram Severe trauma Traumatic coagulopathy 　　随着我国交通运输及工业现代化的高速发展，严重创伤出现越来越多的，对创伤的抢救和治疗要求也越来越高。创伤性凝血病（Traumatic coagulopathy disease TCD）是创伤早期出现的急性凝血功能紊乱，它是相互影响的多重机制共同作用的结果。目前认为组织损伤、休克、酸中毒、血液稀释、低体温和炎性反应是TCD的6 个关键启动因