血栓弹力图用于诊断颅脑损伤后创伤性凝血病的临床研究

目的 观察血栓弹力图(TEG)检测用于诊断颅脑损伤后创伤性凝血病的临床效果及预后评估价值.方法 以2018年12月-2021年2月台州市中医院收治的200例颅脑损伤患者为研究对象,所有患者均分别进行常规凝血项目检测和TEG检测,统计常规凝血项目检测和'TEG检测在颅脑损伤后不同时间对于创伤性凝血病的检出情况,比较不同时...

Clinical study of thromboelastography in the diagnosis of traumatic coagulopathy after craniocerebral injury

  Objective  To observe the clinical effect and prognostic value of thromboelastography (TEG) in the diagnosis of traumatic coagulopathy after craniocerebral injury.   Methods   Total 200 patients with acute craniocerebral injury in our hospital were selected as the research objects from December 2018 to February 2021. All patients were detected by routine coagulation test and TEG test. The detection of traumatic coagulopathy by routine coagulation test and TEG test at different time after craniocerebral injury was statistically analyzed. The TEG indexes of patients with craniocerebral injury at different time and different prognosis levels were compared, and the related risk factors of death in patients with traumatic coagulopathy were analyzed.   Results   ]The detection rate of TEG in 4 hours and 12 hours of traumatic coagulopathy (34.50% and 63.00%) after craniocerebral injury was significantly higher than that of conventional coagulopathy (18.50% and 40.50%, χ2=13.143, 20.275, P < 0.001), and the incidence of traumatic coagulopathy in patients with severe craniocerebral injury (84.81%) was significantly higher than that in patients with non-severe craniocerebral injury (48.76%, χ2=26.647, P < 0.001). The R and K values at 12 h after injury were significantly higher than those at 4 h after injury, while the angle and Ma values were significantly lower than those at 4 h after injury (P < 0.001). There was no significant difference between the R value of the dead patients and the survival patients (t=1.583, P=0.116), but the K value was significantly higher than the survival patients, and the angle value and MA value were significantly lower than the survival patients (P < 0.001). The MA value was the related risk factor of death in patients with traumatic coagulopathy.   Conclusion   TEG detection can dynamically monitor the early changes of coagulation function in patients with craniocerebral injury, effectively identify the occurrence of traumatic coagulopathy, and can be used for early evaluation of prognosis of patients with traumatic coagulopathy after craniocerebral injury.