Hanke Alexander A, Horstmann Hauke, Wilhelmi Michaela
aKlinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover bKlinik für Orthopädie, Diakovere Annastift cKlinik für Unfallchirurgie, Medizinische Hochschule Hannover, Hannover, Germany.
Curr Opin Anaesthesiol. 2017 Apr;30(2):250-256. doi: 10.1097/ACO.0000000000000448.
Knowledge of trauma-induced coagulopathy has been grown in the past and point-of-care suitable devices for coagulation testing have been introduced. Methodology and clinical application of different systems for point-of-care coagulation monitoring are shown with a focus on thrombelastography as measured by TEG, rotational thromboelastometry as measured by ROTEM and impedance aggregometry as measured by the multiplate analyser and ROTEM platelet.
Two different methods for point-of-care coagulation assessment are available: viscoelastic tests (ROTEM, TEG) and impedance aggregometry. In different settings these methods have been evaluated in various publications pointing out the possibility of reducing transfusion requirements, transfusion-related side effects, and resulting costs.
Point-of-care assessment of coagulation in trauma patients appears to be at least promising. However, because published data mostly are of retrospective or observational nature only, there is a need for prospective, randomized and controlled studies.
过去人们对创伤性凝血病的认识有所增加，并且已经引入了适合床旁检测的凝血检测设备。本文展示了不同床旁凝血监测系统的方法和临床应用，重点介绍了血栓弹力图（通过血栓弹力图仪 [TEG] 测量）、旋转血栓弹力测定法（通过旋转血栓弹力图仪 [ROTEM] 测量）以及阻抗聚集测定法（通过多板式分析仪和 ROTEM 血小板功能分析仪测量）。
有两种不同的床旁凝血评估方法：粘弹性检测（ROTEM、TEG）和阻抗聚集测定法。在不同环境下，这些方法已在各种出版物中得到评估，指出了减少输血需求、输血相关副作用及成本的可能性。
创伤患者凝血功能的床旁评估似乎至少是有前景的。然而，由于已发表的数据大多仅具有回顾性或观察性，因此需要进行前瞻性、随机对照研究。
