高原地区患者术前凝血功能特征及血栓弹力图评估凝血功能的价值研究

发布时间：2018-05-05 00:39

本文选题：高原地区 + 凝血功能　；参考：《中国现代医学杂志》2017年17期

【摘要】：目的探讨高原地区患者术前凝血功能特征及血栓弹力图评估凝血功能的价值。方法将青海红十字医院2015年1月-2016年1月收治的择期手术患者60例纳入研究,根据高原居住时间不同将所有入组患者分为长期在高原居住的观察组(n=30)、初到高原的对照组(n=30)。术前及术后3 h测定两组患者的凝血、血常规、血栓弹力图等指标,进一步分析血栓弹力图与凝血、血常规的相关性。结果观察组患者的术前及术后3 h的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)低于对照组,纤维蛋白原(FIB)、血小板(PLT)、血红蛋白(HGB)、红细胞比容(Hct)及红细胞(RBC)高于对照组(P0.05);观察组患者的术前及术后3 h R值、CL30水平低于对照组,MA水平高于对照组(P0.05);血栓弹力图中的R值、CL30与PT、APTT呈正相关,与FIB、PLT、HGB、Hct及RBC呈负相关(P0.05),MA与PT、APTT呈负相关(P0.05),与FIB、PLT、HGB、Hct、RBC呈正相关(P0.05)。结论高原地区患者存在高凝状态,血栓弹力图可以直观评估患者的凝血功能及血常规状态,可用于临床凝血状态监测及早期采取干预措施,具有积极的临床意义。
[Abstract]:Objective to investigate the characteristics of preoperative coagulation function and the value of thromboelastography in evaluating coagulation function in patients with high altitude. Methods A total of 60 selected surgical patients admitted to Qinghai Red Cross Hospital from January 2015 to January 2016 were included in the study. According to the time of residence at high altitude, all the patients were divided into two groups: the observation group with long-term residence at high altitude and the control group with the control group. The blood clotting, blood routine and thromboelastography were measured before and 3 hours after operation, and the correlation between thromboelastography and coagulation and blood routine was further analyzed. Results the prothrombin time (PTT) and activated partial thromboplastin time (APTT) in the observation group were lower than those in the control group. The levels of fibrinogen FIBP, PLTX, HGB, HCT and RBC were higher than those of the control group (P 0.05), and the level of CL30 was lower in the observation group than that in the control group at 3 h after operation (P 0.05); in thromboelastogram, the level of CL30 was lower than that in the control group (P 0.05). The R value of CL30 was positively correlated with that of PTT APTT. There was a negative correlation between HGB Hct and RBC (P0.05) and P0.05 (P 0.05), and a positive correlation (P0.05) with P0.05 (P 0.05). Conclusion there is hypercoagulable state in patients at high altitude. Thromboelastogram can be used to evaluate coagulation function and blood routine state of patients directly and can be used to monitor coagulation status in clinic and to take early intervention measures. It has positive clinical significance.
【作者单位】：青海红十字医院麻醉科;
【基金】：青海省自然科学基金(No:2015-ZJ-913)
【分类号】：R446.1

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