Reikvam Håkon, Steien Egil, Hauge Bjørn, Liseth Knut, Hagen Kristin Gjerde, Størkson Rolf, Hervig Tor
Institute of Internal Medicine, Haukeland University Hospital, 5021 Bergen, Norway.
Transfus Apher Sci. 2009 Apr;40(2):119-23. doi: 10.1016/j.transci.2009.01.019. Epub 2009 Feb 26.
Thromboelastography (TEG) records the continuous profiles of whole blood coagulation by measurement of the viscoelastic changes associated with fibrin polymerization, and thereby provides a global assessment of haemostatic function. In the past decades there has been an increasing interest for TEG in clinical practice. In this paper we present the rationale for the method and a discussion of the possible application of TEG.
This review is based on personal experience and literature retrieved from searches in PubMed.
Currently TEG is used with standard coagulation tests to decrease the risk for bleeding and reduce the homologous blood transfusion in cardiac surgery with cardiopulmonary bypass and in liver surgery. Other applications are severe trauma, obstetric medicine, haemophilia and hypercoagulable conditions. Development of a modified TEG, using heparin in combination with reptilase and factor XIIIa, has the potential to monitor the effects of platelet inhibiting drugs. It should be kept in mind that the TEG is a global test of coagulation and therefore the need for additional haemostatic tests should be evaluated when applicable. The main advantage for TEG is an inexpensive patient near method for quick evaluation of the patient's global haemostatic system. Used by experienced hands, TEG is a valuable haemostatic test, the future of which is already present.
血栓弹力图（TEG）通过测量与纤维蛋白聚合相关的粘弹性变化来记录全血凝血的连续过程，从而对止血功能进行全面评估。在过去几十年中，临床实践对TEG的兴趣日益增加。本文阐述了该方法的基本原理，并讨论了TEG可能的应用。
本综述基于个人经验以及从PubMed检索到的文献。
目前，TEG与标准凝血试验联合使用，以降低体外循环心脏手术和肝脏手术中出血风险并减少同种异体输血。其他应用包括严重创伤、妇产科医学、血友病和高凝状态。一种改良的TEG，将肝素与蛇毒凝血酶和凝血因子ⅩⅢa联合使用，有可能监测血小板抑制药物的效果。应记住，TEG是一种全面的凝血试验，因此在适用时应评估是否需要额外的止血试验。TEG的主要优势在于它是一种成本低廉的床边检测方法，可快速评估患者的整体止血系统。由经验丰富的人员操作时，TEG是一项有价值的止血试验，其未来已现端倪。
