非体外循环冠脉搭桥术中凝血弹力图变化及与Sonoclot凝血仪监测指标的相关性研究

发布时间：2018-04-15 06:05

本文选题：非体外循环冠脉搭桥 + TEG　；参考：《首都医科大学》2014年硕士论文

【摘要】：目的研究非体外冠脉搭桥术中血栓弹力图(TEG)和sonoclot凝血仪监测指标的相关性，同时也研究非体外冠脉搭桥术中凝血功能的变化规律。方法收集首都医科大学附属北京朝阳医院心外科择期行不停跳冠脉搭桥手术的患者30例，分别于麻醉诱导后(T1)、给予鱼精蛋白后10min(T2)、关胸缝皮结束即刻(T3)三个时点分别采集静脉血检测，记录凝血指标：硅燥土激活的全血血栓弹性描记图(thrombelastography，TEG)，指标包括R值、K值、Alpha角和MA值；玻璃珠激活的全血SCA，指标包括ACT、CR和PF值。结果1：R与gbACT成正相关，r=0.752，p0.01，CR与K成负相关，r=-0.734,p0.01，CR与Alpha角成正相关，r=0.659，p0.01，MA与PF成正相关，r=0.497，p0.01。2，，SCA显示：与术前相比，术后gbACT明显延长(P0.05)，CR、PF明显降低（P0.05)；TEG显示：与术前相比，R明显延长(P0.05)，K，Alpha角差异无统计学意义，MA显著降低(P0.05)。结论 1:OPCAB手术导致患者凝血功能障碍，体现为gbACT延长，CR下降，PF降低。 2：SCA与TEG的凝血指标中R与gbACT，CR与K，CR与Alpha角，PF与MA四组指标均有良好的相关性。 3：和SCA相比，TEG基本准确反映OPCABG患者凝血状态。但其准确性、稳定性等方面还需要在今后临床上进行验证。
[Abstract]:PurposeTo study the correlation between thromboelastogram (TEG) and sonoclot coagulation monitoring index in non-external coronary artery bypass grafting, and to study the change of coagulation function in non-external coronary artery bypass grafting.MethodA total of 30 patients undergoing elective coronary artery bypass surgery in Beijing Chaoyang Hospital affiliated to Capital Medical University were selected. Venous blood was collected at three time points, namely T1 after anesthesia induction, protamine 10 min after administration of protamine, and T3 at the end of closure of thoracic suture skin.The indexes of coagulation were as follows: thromboelastic thrombography activated by silica dry soil, including R value, K value, Alpha angle and MA value, and vitreous bead activated whole blood SCA, including ACTA CR and PF values.Results 1: r was positively correlated with gbACT 0.752p0.01A, CR was negatively correlated with K r-0.734p0.01A, CR was positively correlated with Alpha angle 0.659p 0.01A was positively correlated with PF 0.497p 0.01.2SCA showed that, compared with pre-operation, the ratio of CR to Alpha was 0.497p 0.01.2SCA showed that there was no significant correlation between CR and Alpha, and the correlation between CR and Alpha was 0.497p 0.01.2SCA.After operation, gbACT was significantly prolonged (P 0.05) and the PF was significantly decreased (P 0.05). The results showed that there was no significant difference in the angle of K 伪 between the two groups compared with that before operation. However, MA was significantly lower than that before operation (P 0.05).ConclusionCoagulation dysfunction was caused by 1:OPCAB operation, which showed that gbACT prolonged CR decreased and PF decreased.There was a good correlation between R and gbACTCR and Alpha angle PF and MA in the coagulation index of 2:SCA and TEG.3: compared with SCA, the clotting state of OPCABG patients was basically reflected accurately.However, its accuracy, stability and other aspects need to be verified in the future.
【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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