摘要
目的分析血栓弹力图(TEG)指导下输血和监测肝素是否残留对心外术后心功能的影响。方法80例进行心外手术的患者,随机分为对照组和观察组,各40例。对照组在传统凝血项监测指导下输血,观察组在血栓弹力图监测指导下输血,并监测肝素是否残留。比较两组患者手术前后凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]、血红蛋白(Hb)水平及术后引流量、气管插管时间、体外循环时间、心功能情况。结果术后,观察组Hb(99.31±7.35)g/L高于对照组的(77.41±6.94)g/L,PT(15.17±2.09)s、APTT(27.83±5.02)s均短于对照组的(18.39±2.46)、(31.04±5.17)s,差异有统计学意义(P<0.05)。观察组术后引流量(561.28±20.37)ml少于对照组的(607.41±28.31)ml,气管插管时间(7.83±1.13)h、体外循环时间(1.26±0.06)h均短于对照组的(8.63±1.16)、(1.49±0.08)h,差异有统计学意义(P<0.05)。观察组术后心功能优于对照组,差异有统计学意义(P<0.05)。结论心外术后在血栓弹力图指导下输血可明显改善患者心功能,保护凝血功能,联合监测肝素是否残留对规范临床肝素剂量使用和治疗时间、降低出血事件、保障患者手术安全方面具有积极意义,可为合理输血治疗提供科学依据。
Objective To analyze the influence of blood transfusion and monitoring of heparin residue under the guidance of thromboelastogram(TEG)on cardiac function after extracardiac surgery.Methods A total of 80 patients undergoing extracardiac surgery were randomly divided into control group and observation group,with 40 cases in each group.The control group received blood transfusion under the guidance of traditional coagulation monitoring,and the observation group received blood transfusion under the guidance of thrombologram and monitored for residual heparin.Both groups were compared in terms of coagulation function indexes[prothrombin time(PT),activated partial thrombin time(APTT)]and hemoglobin(Hb)levels before and after surgery,postoperative drainage volume,endotracheal intubation time,cardiopulmonary bypass time,and cardiac function.Results After surgery,Hb level of(99.31±7.35)g/L in the observation group was higher than that of(77.41±6.94)g/L in the control group;PT level of(15.17±2.09)s and APTT of(27.83±5.02)s in the observation group were shorter than those of(18.39±2.46)and(31.04±5.17)s in the control group;the differences were statistically significant(P<0.05).The postoperative drainage volume of(561.28±20.37)ml in the observation group was less than that of(607.41±28.31)ml in the control group;the endotracheal intubation time of(7.83±1.13)h and cardiopulmonary bypass time of(1.26±0.06)h in the observation group were shorter than those of(8.63±1.16)and(1.49±0.08)h in the control group;the differences were statistically significant(P<0.05).The cardiac function in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Blood transfusion under the guidance of thromboelastogram after extracardiac surgery can significantly improve the cardiac function and protect the coagulation function of patients.Joint monitoring of heparin for residue has positive significance in regulating clinical heparin dosage and treatment time,reducing bleeding events,and guaranteeing patients'surgical safety,and can provide scientific basis for rational transfusion therapy.
作者
顾红苍
GU Hong-cang(Department of Cardiothoracic Surgery,Shanxian County Hygieia Hospital,Heze 274300,China)
出处
《中国实用医药》
2023年第14期81-84,共4页
China Practical Medicine
关键词
血栓弹力图
监测肝素
心外术后
心功能
Thromboelastogram
Monitoring heparin
After extracardial surgery
Cardiac function
