【摘要】：目的探討在血栓彈力圖(thromboelastography,TEG)指導(dǎo)下血小板輸注治療對口服抗血小板藥物腦出血患者圍手術(shù)期出血情況及輸血量的影響。方法回顧性分析30例行急診手術(shù)治療的抗血小板藥物基底節(jié)區(qū)腦出血患者,其中12例行血小板輸注,比較在TEG指導(dǎo)下有無輸注血小板治療對術(shù)中、術(shù)后出血量及輸血量的影響。結(jié)果術(shù)前兩組病例凝血常規(guī)檢查在正常范圍,但血栓彈力圖提示血小板功能過度抑制(血小板抑制率90%),比較兩組病例術(shù)中出血量(t=-3.998,P=0.008)、輸血總量(Z=-3.245,P=0.001)、術(shù)后血腫殘余量(t=-2.909,P=0.043)、引流量(t=-8.790,P=0.041),提示差異有統(tǒng)計(jì)學(xué)意義。輸血小板組1例,未輸血小板組4例行二次手術(shù),兩者比較無統(tǒng)計(jì)學(xué)意義(χ~2=1,P=0.317)。結(jié)論 TEG檢測指標(biāo)能夠更全面準(zhǔn)確地評估患者術(shù)前凝血功能,研究提示術(shù)前血小板輸注,一定程度上改善抗血小板治療后腦出血患者術(shù)中、術(shù)后出血情況,減少輸血量。
[Abstract]:Objective to investigate the effect of platelet infusion under thromboelastography (thromboelastography,TEG) on perioperative bleeding and blood transfusion in patients with oral antiplatelet drug intracerebral hemorrhage. Methods Thirty patients with intracerebral hemorrhage of the basal ganglia treated by emergency operation were analyzed retrospectively. Among them, 12 cases were given platelet transfusion. The effect of platelet transfusion under the guidance of TEG on intraoperative and postoperative blood loss and blood transfusion was compared. Results Coagulation routine examination of the two groups was in normal range before operation. But thromboelastography showed that the platelet function was suppressive (platelet inhibition rate 90%). The blood loss (t -3.998), the total blood transfusion (ZP0.001), the residual hematoma volume (t-2.909 P0.043) and the drainage volume (t-8.790 P0.041) were compared between the two groups, which indicated that there was significant difference between the two groups. Platelet transfusion group (1 case) and no platelet transfusion group (4 cases) underwent secondary operation. There was no significant difference between the two groups (蠂 ~ 2 / 2 ~ (1) P ~ (1) P ~ (0. 317). Conclusion TEG can evaluate the preoperative coagulation function more comprehensively and accurately. The study suggests that the preoperative platelet transfusion can improve the postoperative bleeding and reduce the blood transfusion in the patients with cerebral hemorrhage after anti-platelet therapy to a certain extent.
【作者單位】： 福建醫(yī)科大學(xué)附屬第二醫(yī)院福建醫(yī)科大學(xué)附屬第二臨床學(xué)院;
【基金】：泉州市科技計(jì)劃項(xiàng)目(編號(hào):2016Z049)
【分類號(hào)】：R651.1

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