血小板输注治疗对抗血小板药物脑出血患者围手术期出血的预防

发布时间：2018-09-07 15:01

【摘要】：目的探讨在血栓弹力图(thromboelastography,TEG)指导下血小板输注治疗对口服抗血小板药物脑出血患者围手术期出血情况及输血量的影响。方法回顾性分析30例行急诊手术治疗的抗血小板药物基底节区脑出血患者,其中12例行血小板输注,比较在TEG指导下有无输注血小板治疗对术中、术后出血量及输血量的影响。结果术前两组病例凝血常规检查在正常范围,但血栓弹力图提示血小板功能过度抑制(血小板抑制率90%),比较两组病例术中出血量(t=-3.998,P=0.008)、输血总量(Z=-3.245,P=0.001)、术后血肿残余量(t=-2.909,P=0.043)、引流量(t=-8.790,P=0.041),提示差异有统计学意义。输血小板组1例,未输血小板组4例行二次手术,两者比较无统计学意义(χ~2=1,P=0.317)。结论 TEG检测指标能够更全面准确地评估患者术前凝血功能,研究提示术前血小板输注,一定程度上改善抗血小板治疗后脑出血患者术中、术后出血情况,减少输血量。
[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.
【作者单位】：福建医科大学附属第二医院福建医科大学附属第二临床学院;
【基金】：泉州市科技计划项目(编号:2016Z049)
【分类号】：R651.1

【相似文献】