血小板抗体协同血栓弹力图检测对心脏手术围术期输血的指导作用

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摘要目的研究血小板抗体协同血栓弹力图检测对心脏手术围术期输血的指导作用。方法选取2017年8月～2018年12月贵港市人民医院拟行心脏外科手术治疗的患者100例作为观察对象，通过随机数字表法将其均分成联合组（50例）与对照组（50例）。对照组通过血栓弹力图检测进行输血指导，联合组则采用血小板抗体协同血栓弹力图检测进行输血指导。分别比较两组在围术期血液成分输注量情况，输注1、24 h时的校正指数（CCI），并发症发生情况，住院时间以及出院时血红蛋白（Hb）水平等方面的差异。结果联合组在红细胞、新鲜冷冻血浆、冷沉淀、血小板输注量方面低于对照组，差异有统计学意义（均P ＜ 0.05）。与输注1 h比较，两组输注24 h的CCI值均降低，差异有统计学意义（均P ＜ 0.05），联合组输注1、24 h的CCI值显著高于对照组，差异有统计学意义（均P ＜ 0.05）。联合组并发症总发生率显著低于对照组，差异有统计学意义（均P ＜ 0.05）。联合组住院时间短于对照组，出院时Hb水平低于对照组，差异均有统计学意义（均P ＜ 0.05）。结论血小板抗体协同血栓弹力图检测应用于心脏手术围术期输血指导中效果显著，有利于减少各成分血输注量，降低并发症发生风险，促进患者早日康复，值得临床推广应用。

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	林就孟1 张颖2 曾灏3 韦赐秋1 黄圣斌4

关键词 ：心脏手术, 围术期输血, 血小板抗体, 血栓弹力图, 指导作用

Abstract：Objective To study the guiding role of platelet antibody in collaboration with thrombolytic elastogram detection in perioperative blood transfusion of cardiac surgery. Methods From August 2017 to December 2018, a total of 100 patients planned to receive cardiac surgery in Guigang City People′s Hospital were selected as the subjects for observation, and all of them were divided into the combined group (50 cases) and the control group (50 cases) by random number table method. The control group was received blood transfusion instruction by thrombolytic elastogram detection, while the combined group was received blood transfusion instruction by platelet antibody in collaboration with thrombolytic elastogram detection. Perioperative blood component transfusion, the corrected count increment (CCI) at 1, 24 hours after infusion, the occurrence of complications, hospitalization time and the level of hemoglobin (Hb) at discharge were compared between the two groups. Results Red blood cells, fresh frozen plasma, cryoprecipitation and platelet transfusion of combined group were lower than those of control group, and the differences were statistically significant (all P ＜ 0.05). Compared with 1 hour after infusion, the CCI value of 24 hours after infusion in both groups were lower, and the differences were statistically significant (all P ＜ 0.05). The CCI value of combined group at 1 hour and 24 hours after infusion were higher than those of control group, and the differences were statistically significant (all P ＜ 0.05). The total incidence of complications in combined group were lower than those in control group, and the differences were statistically significant (all P ＜ 0.05). Hospitalization time in combined group was shorter than that in control group, while Hb level in combined group was lower than that in control group, and the differences were statistically significant (all P ＜ 0.05). Conclusion The platelet antibody and thrombolytic elastogram detection have significant effects in the guidance of perioperative blood transfusion during cardiac surgery, which is conducive to reducing the blood transfusion volume of each component, decreasing the risk of complications, and promoting the early recovery of patients. It is worthy of clinical application.

Key words： Cardiac surgery Perioperative blood transfusion Platelet antibody Thromboelastic elastogram Guiding role

基金资助:广西科技计划项目（AD17195042）。

引用本文:

林就孟1 张颖2 曾灏3 韦赐秋1 黄圣斌4. 血小板抗体协同血栓弹力图检测对心脏手术围术期输血的指导作用[J]. 中国医药导报, 2019, 16(34): 100-103,116.
LIN Jiumeng1 ZHANG Ying2 ZENG Hao3 WEI Ciqiu1 HUANG Shengbin4. The guiding role of platelet antibody in collaboration with thrombolytic elastogram detection in perioperative blood transfusion of cardiac surgery. 中国医药导报, 2019, 16(34): 100-103,116.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I34/100

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