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血栓弹力描记术在评估脓毒症患者凝血功能障碍中的应用。

Thromboelastography in the evaluation of coagulation disorders in patients with sepsis.

出版信息

Turk J Med Sci. 2014;44(2):267-72. doi: 10.3906/sag-1210-99.

Abstract

AIM

Unbalanced hemostasis and disseminated intravenous coagulopathy serve as key participants in organ dysfunction and disability. In this study we evaluated the coagulation profiles of patients diagnosed with systemic inflammatory syndrome (SIRS)-sepsis and multiple organ dysfunction syndrome. We also researched coagulation in sepsis by comparing thromboelastography (TEG) data with those of nonsepsis patients to determine the usefulness of the TEG device.

MATERIALS AND METHODS

Data were collected from 55 anesthesiology and surgery intensive care unit (ICU) patients: 21 with SIRS-sepsis (Group S) and 34 patients without SIRS-sepsis (Group C). Blood samples were taken upon admission to the ICU (t1) and on day 3 of the ICU stay (t2). TEG data (R = reaction time, K = coagulation time, a = alpha angle, and MA = maximum amplitude) were recorded. TEG parameters were compared with routine coagulation and hemogram studies.

RESULTS

The mean R value in Group C was higher than that of Group S at both t1 and t2. Group S had a significantly lower K value and higher alpha angle at t1 compared to Group C (P < 0.05).

CONCLUSION

Hypercoagulability was observed in SIRS-sepsis patients in the ICU, as measured with TEG. We believe that TEG will be a useful tool in the evaluation of coagulation disorders developing in septic critically ill patients.

摘要

目的

失衡的止血和弥散性血管内凝血作为器官功能障碍和残疾的关键参与者。在这项研究中,我们评估了诊断为全身炎症反应综合征(SIRS)-败血症和多器官功能障碍综合征的患者的凝血谱。我们还通过将血栓弹性描记术(TEG)数据与非败血症患者的数据进行比较来研究败血症中的凝血情况,以确定 TEG 设备的有用性。

材料和方法

从 55 名麻醉学和外科重症监护病房(ICU)患者中收集数据:21 名患有全身炎症反应综合征(SIRS)-败血症(组 S)和 34 名无全身炎症反应综合征(SIRS)-败血症患者(组 C)。在入住 ICU 时(t1)和 ICU 入住第 3 天(t2)采集血样。记录 TEG 数据(R =反应时间,K =凝血时间,a =α角,MA =最大振幅)。将 TEG 参数与常规凝血和血液学研究进行比较。

结果

在 t1 和 t2 时,组 C 的平均 R 值均高于组 S。与组 C 相比,组 S 在 t1 时的 K 值明显较低,α角较高(P<0.05)。

结论

ICU 中的 SIRS-败血症患者存在高凝状态,可通过 TEG 测量。我们认为 TEG 将成为评估脓毒症危重症患者凝血障碍的有用工具。

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