Romašovs Andris, Stāka Aiga, Ivanova Jelena, Puķītis Aldis
Pauls Stradins Clinical University Hospital, Latvia.
University of Latvia, Latvia.
Clin Exp Hepatol. 2025 Jun;11(2):147-151. doi: 10.5114/ceh.2025.151768. Epub 2025 Jun 26.
The primary objective of this study was to assess the impact of thromboelastography (TEG) on the decision-making process of gastroenterologists and hepatologists regarding blood component (BC) transfusions in patients with decompensated cirrhosis before invasive manipulations.
This study was a prospective, single-center, randomized controlled trial. Throughout the trial, the decision-making process was not actively influenced. However, TEG results were made available to the physicians, offering recommendations regarding the need for specific BC transfusions. To assess whether the availability of TEG data influences clinical decision-making, a subsequent statistical analysis was conducted.
After application of exclusion criteria, 20 patients were enrolled in the study. The results showed that in the TEG group, the need for BC transfusions was 20% lower than in the control group, although this difference was not statistically significant ( = 0.384). When hypothesizing that all patients in the TEG group would have received BC transfusions prior to the procedure, TEG was estimated to reduce transfusion requirements by 69.2%. However, this reduction was also not statistically significant ( > 0.05).
In settings where nearly all physicians were familiar with the concept of hemostatic changes in liver cirrhosis, TEG was estimated to reduce transfusion requirements by 20%.
本研究的主要目的是评估血栓弹力图（TEG）对胃肠病学家和肝病学家在失代偿期肝硬化患者进行侵入性操作前关于血液成分（BC）输血决策过程的影响。
本研究是一项前瞻性、单中心、随机对照试验。在整个试验过程中，决策过程未受到积极影响。然而，TEG结果会提供给医生，并就特定BC输血的必要性给出建议。为评估TEG数据的可用性是否会影响临床决策，随后进行了统计分析。
应用排除标准后，20名患者纳入研究。结果显示，在TEG组中，BC输血的需求比对照组低20%，尽管这一差异无统计学意义（ = 0.384）。假设TEG组所有患者在手术前都接受了BC输血，估计TEG可使输血需求减少69.2%。然而，这一减少也无统计学意义（ > 0.05）。
在几乎所有医生都熟悉肝硬化止血变化概念的情况下，估计TEG可使输血需求减少20%。
