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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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

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	LIN Jiumeng1 ZHANG Ying2 ZENG Hao3 WEI Ciqiu1 HUANG Shengbin4

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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[J]. 中国医药导报, 2019, 16(34): 100-103,116.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I34/100

[1] Zhou H，Chen L，He H. Intraoperative and postoperative effects of TEG-guided platelet transfusion on antiplatelet drug-related intracerebral hemorrhage patients [J]. Exp Ther Med，2019，17（3）：2263-2267.
[2] 和爽，赵振国.血栓弹力图在腹部创伤患者目标导向性输血中的临床价值[J].中华卫生应急电子杂志，2017，3（5）：282-286.
[3] 唐晓春.肝癌患者血栓弹力图与常规凝血四项相关性及其在指导临床输血中的应用[J].国际医药卫生导报，2018，24（5）：743-746.
[4] 郭明，张仕运，张晓明，等.血栓弹力图在成人心脏瓣膜置换术后监测凝血功能及指导临床输血的应用价值研究[J].中国心血管病研究，2018，16（7）：638-641.
[5] Yildirim F，Tuncer B，Ozbakkaloglu A，et al. Thromboelastogram reduces blood use by inspecting coagulation in heart surgery [J]. Asian Cardiovasc Thorac Ann，2016，24（5）：441-444.
[6] 刘凤华，韩艳秋.血小板减少病人血小板抗体阳性的检测及临床意义[J].内蒙古医科大学学报，2018，40（5）：453-455.
[7] 中华人民共和国卫生部.临床输血技术规范[J].临床输血与检验，2000（3）：1-11
[8] Paone G，Likosky DS，Brewer R，et al. Transfusion of 1 and 2 units of red blood cells is associated with increased morbidity and mortality [J]. Ann Thorac Surg，2014，97（1）：87-93.
[9] Yoon JU，Cheon JH，Choi YJ，et al. The correlation between conventional coagulation tests and thromboelastography in each phase of liver transplantation [J]. Clin Transplant，2019，33（3）：13 478-13 479.
[10] Drumheller BC，Stein DM，Moore LJ，et al. Thromboelastography and rotational thromboelastometry for the surgical intensivist：A narrative review [J]. J Trauma Acute Care Surg，2019，86（4）：710-721.
[11] 张其俊，何爱文.血栓弹力图仪在危重症创伤出血患者凝血功能监测的应用及对临床输血治疗的指导[J].浙江创伤外科，2018，23（4）：741-743.
[12] 覃小矿，马曙轩，侯云生，等.血栓弹力图检测在指导心脏术后患儿成分输血中的应用价值[J].广西医学，2017， 39（10）：1521-1523.
[13] Maeda T，Nakagawa K，Murata K，et al. Identifying patients at high risk of heparin-induced thrombocytopenia-associated thrombosis with a platelet activation assay using flow cytometry [J]. Thromb Haemost，2017，117（1）：127-138.
[14] 张春玉，李小霞，邓琼，等.血栓弹力图在老年急性冠脉综合征患者抗血小板治疗有效性与安全性评估中的应用[J].中国医学创新，2018，15（16）：27-30.
[15] 王妍，吴杰，孙涛，等.血栓弹力图对中晚期乳腺癌患者凝血功能的评价及预测转移的临床价值[J].中国医药导报，2017，14（35）：82-85.
[16] Hayashi T，Hirayama F. Advances in alloimmune thrombocytopenia：perspectives on current concepts of human platelet antigens，antibody detection strategies，and genotyping [J]. Blood Transfus，2015，13（3）：380-390.
[17] 张秋会，张婧，刘丽娜，等.多次输血后患者血小板输注无效的血小板抗体检测与分析[J].临床输血与检验，2015，17（5）：409-412.
[18] 张水建，曾祥文，陈超，等.血小板抗体及血栓弹力图检测在指导心脏手术患者围术期输血中的意义[J].血栓与止血学，2018，24（5）：748-751.
[19] Saeveraas SB，Seghatchian J，Sivertsen J，et al. The use of thromboelastography（TEG）in massively bleeding patients at Haukeland University Hospital 2008-15 [J]. Transfus Apher Sci，2019，58（1）：117-121.
[20] 高逸之，王志良，李超男，等.心肌梗死合并糖尿病患者血栓弹力图变化探讨[J].中国医药导报，2018，15（2）：50-53.
[21] 范宝玉，王娟，赵海磊，等.危重烧伤患者血栓弹力图、凝血指标及血小板变化的临床意义[J].中国医学创新，2018，15（6）：103-106.
[22] 刘喆.血栓弹力图（TEG）在评价体外循环心脏外科手术围手术期凝血功能改变中的应用[D].石家庄：河北医科大学，2015.
[23] 孙春玲.探究反复输血治疗的血液病患者行血小板抗体筛查及配型对预防免疫性输注无效的临床意义[J].现代诊断与治疗，2018，29（7）：1080-1082.
[24] 周长平，王义桥，李元海，等.血栓弹力图在婴幼儿体外循环心脏直视手术围术期输血中的应用[J].中国输血杂志，2018，31（5）：478-481.
[25] 史良玉.血小板抗体检测在评估反复输血患者输注状态中的应用价值[J].临床研究，2018，26（6）：15-16.
[26] 周鑫，胡天勇，关怀敏，等.血栓弹力图及基因检测在急性冠脉综合征抗栓治疗中的应用[J].中国医药导报，2017，14（12）：39-42.
[27] Russell L，Holst LB，Lange T，et al. Effects of anemia and blood transfusion on clot formation and platelet function in patients with septic shock：a substudy of the randomized TRISS trial [J]. Transfusion，2018，58（12）：2807-2818.