大型非急诊骨科手术中的凝血监测与输血——一项观察性研究。
Coagulation monitoring and transfusion in major non-emergency orthopaedic surgery - An observational study.
作者信息
Hanke Alexander A, Bartlau Jan, Flöricke Felix, Przemeck Michael, Horstmann Hauke, Weber-Spickschen Thomas S, Sieg Lion, Schumacher Carsten
机构信息
Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule, Hannover, Germany.
Institut für Sportsmedizin, Medizinische Hochschule, Hannover, Germany.
出版信息
J Orthop. 2020 Mar 25;22:22-28. doi: 10.1016/j.jor.2020.03.032. eCollection 2020 Nov-Dec.
Abstract
OBJECTIVE
Perioperative coagulation monitoring and transfusions were evaluated.
METHODS
70 cases were included. Time points: before (PRE), after surgery (POST), day 1, day 3, day 7. Standard and patient near tests were assessed. Groups were: Transfused (TG); Control (CG).
RESULTS
23 patients were transfused (TG), 47 were not (CG). PRE haemoglobin was reduced, coagulation time (CT) was prolonged in TG. FIBTEM decrease was higher in TG. Leukocytes were elevated in TG. ASPI decreased, TRAP and ADP aggregability increased in both groups.
CONCLUSION
CT, haemoglobin and fibrinogen were associated with transfusion. TRAP and ADP aggregability increased and could account for thromboembolism.
摘要
目的
评估围手术期凝血监测及输血情况。
方法
纳入70例患者。时间点包括：术前（PRE）、术后（POST）、第1天、第3天、第7天。评估标准检测和患者床边检测。分组为：输血组（TG）；对照组（CG）。
结果
23例患者接受输血（TG），47例未输血（CG）。输血组术前血红蛋白降低，凝血时间（CT）延长。输血组FIBTEM降低更明显。输血组白细胞升高。两组的ASPI均降低，TRAP和ADP聚集性均增加。
结论
凝血时间、血红蛋白和纤维蛋白原与输血有关。TRAP和ADP聚集性增加，可能是血栓栓塞的原因。
相似文献
1
Coagulation monitoring and transfusion in major non-emergency orthopaedic surgery - An observational study.大型非急诊骨科手术中的凝血监测与输血——一项观察性研究。
J Orthop. 2020 Mar 25;22:22-28. doi: 10.1016/j.jor.2020.03.032. eCollection 2020 Nov-Dec.
2
Preoperative plasma fibrinogen concentration, factor XIII activity, perioperative bleeding, and transfusions in elective orthopaedic surgery: A prospective observational study.择期骨科手术中术前血浆纤维蛋白原浓度、因子 XIII 活性、围手术期出血及输血情况：一项前瞻性观察研究。
Thromb Res. 2016 Mar;139:142-7. doi: 10.1016/j.thromres.2016.01.001. Epub 2016 Jan 5.
3
The influence of laboratory coagulation tests and clotting factor levels on Rotation Thromboelastometry (ROTEM(R)) during major surgery with hemorrhage.在大出血的大手术期间，实验室凝血试验和凝血因子水平对旋转血栓弹性描记术（ROTEM(R)）的影响。
Anesth Analg. 2013 Aug;117(2):314-21. doi: 10.1213/ANE.0b013e31829569ac. Epub 2013 Jun 18.
4
A comparative study of viscoelastic hemostatic assays and conventional coagulation tests in trauma patients receiving fibrinogen concentrate.纤维蛋白原浓缩物治疗创伤患者中黏弹性止血检测与常规凝血检测的比较研究。
Clin Chim Acta. 2019 Aug;495:253-262. doi: 10.1016/j.cca.2019.04.066. Epub 2019 Apr 17.
5
Perioperative Thromboelastometry for Adult Living Donor Liver Transplant Recipients with a Tendency to Hypercoagulability: A Prospective Observational Cohort Study.围手术期血栓弹力图在有高凝倾向的成人活体肝移植受者中的应用：一项前瞻性观察队列研究
Transfus Med Hemother. 2018 Nov;45(6):404-412. doi: 10.1159/000489605. Epub 2018 Aug 24.
6
Incidence and risk factors for allogenic blood transfusion during major joint replacement using an integrated autotransfusion regimen. The Rizzoli Study Group on Orthopaedic Anaesthesia.采用综合自体输血方案进行大关节置换术期间异体输血的发生率及危险因素。里佐利骨科麻醉研究小组。
Eur J Anaesthesiol. 2000 Jul;17(7):411-7. doi: 10.1046/j.1365-2346.2000.00693.x.
7
Transfusion in orthopaedic surgery : a retrospective multicentre cohort study.骨科手术中的输血：一项回顾性多中心队列研究。
Bone Jt Open. 2021 Oct;2(10):850-857. doi: 10.1302/2633-1462.210.BJO-2021-0077.R1.
8
The sensitivity and specificity of rotational thromboelastometry (ROTEM) to detect coagulopathy during moderate and severe postpartum haemorrhage: a prospective observational study.旋转血栓弹性测定法（ROTEM）对中重度产后出血时凝血功能障碍的敏感性和特异性：一项前瞻性观察研究。
Int J Obstet Anesth. 2022 Feb;49:103238. doi: 10.1016/j.ijoa.2021.103238. Epub 2021 Nov 8.
9
Rotational thromboelastometry-guided blood product management in major spine surgery.旋转血栓弹性描记术指导下的大型脊柱手术中血液制品管理。
J Neurosurg Spine. 2015 Aug;23(2):239-49. doi: 10.3171/2014.12.SPINE14620. Epub 2015 May 22.
10
A prospective study on the correlation between thromboelastometry and standard laboratory tests - influence of type of surgery and perioperative sampling times.一项关于血栓弹力描记术与标准实验室检测相关性的前瞻性研究——手术类型和围手术期采样时间的影响。
Scand J Clin Lab Invest. 2020 May;80(3):179-184. doi: 10.1080/00365513.2019.1704051. Epub 2019 Dec 17.
引用本文的文献
1
Viscoelastic Hemostatic Assays for Orthopedic Trauma and Elective Procedures.用于骨科创伤和择期手术的粘弹性止血检测
J Clin Med. 2022 Jul 12;11(14):4029. doi: 10.3390/jcm11144029.
本文引用的文献
1
Viscoelastic Blood Tests Use in Adult Cardiac Surgery: Meta-Analysis, Meta-Regression, and Trial Sequential Analysis.黏弹性血液检测在成人心脏手术中的应用：荟萃分析、荟萃回归和试验序贯分析。
J Cardiothorac Vasc Anesth. 2020 Jan;34(1):119-127. doi: 10.1053/j.jvca.2019.06.030. Epub 2019 Jun 28.
2
Perioperative Anemia Management as Part of PBM in Cardiac Surgery - A Narrative Updated Review.心脏手术中作为 PBM 一部分的围手术期贫血管理-更新叙述性综述。
J Cardiothorac Vasc Anesth. 2020 Apr;34(4):1060-1073. doi: 10.1053/j.jvca.2019.06.047. Epub 2019 Jul 4.
3
The Utility of Thromboelastography to Guide Blood Product Transfusion.血栓弹力图在指导输血治疗中的应用。
Am J Clin Pathol. 2019 Sep 9;152(4):407-422. doi: 10.1093/ajcp/aqz074.
4
The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition.欧洲创伤后大出血及凝血功能障碍管理指南：第五版。
Crit Care. 2019 Mar 27;23(1):98. doi: 10.1186/s13054-019-2347-3.
5
Thromboelastography and Thromboelastometry in Assessment of Fibrinogen Deficiency and Prediction for Transfusion Requirement: A Descriptive Review.血栓弹力描记术和血栓弹力测量术在评估纤维蛋白原缺乏症和预测输血需求中的应用：描述性综述。
Biomed Res Int. 2018 Nov 25;2018:7020539. doi: 10.1155/2018/7020539. eCollection 2018.
6
Restrictive Versus Liberal Strategy for Red Blood-Cell Transfusion: A Systematic Review and Meta-Analysis in Orthopaedic Patients.限制与宽松的红细胞输血策略：骨科患者的系统评价和荟萃分析。
J Bone Joint Surg Am. 2018 Apr 18;100(8):686-695. doi: 10.2106/JBJS.17.00375.
7
The bloody mess of red blood cell transfusion.红细胞输血的血腥混乱。
Crit Care. 2017 Dec 28;21(Suppl 3):310. doi: 10.1186/s13054-017-1912-x.
8
Neurosurgical applications of viscoelastic hemostatic assays.神经外科应用粘弹性止血测定。
Neurosurg Focus. 2017 Nov;43(5):E9. doi: 10.3171/2017.8.FOCUS17447.
9
Reversal of trauma-induced coagulopathy using first-line coagulation factor concentrates or fresh frozen plasma (RETIC): a single-centre, parallel-group, open-label, randomised trial.使用一线凝血因子浓缩物或新鲜冰冻血浆逆转创伤性凝血病（RETIC）：一项单中心、平行组、开放标签的随机试验。
Lancet Haematol. 2017 Jun;4(6):e258-e271. doi: 10.1016/S2352-3026(17)30077-7. Epub 2017 Apr 28.
10
Hemotherapy algorithm for the management of trauma-induced coagulopathy: the German and European perspective.创伤性凝血病管理的血液治疗算法：德国及欧洲视角
Curr Opin Anaesthesiol. 2017 Apr;30(2):257-264. doi: 10.1097/ACO.0000000000000433.
Zotero 插件