在外科手术期间的血小板造影:一篇文献评论
Vendhan Ramanujam1, Stephen DiMaria1, Vivek Varma1
1Department of Anesthesiology, Rhode Island Hospital/The Warren Alpert Medical School of Brown University, Providence, USA.
Cureus
|June 26, 2023
概括
粘弹性测试,如血栓弹性扫描 (TEG),在手术期间提供动态凝血评估,优于传统的静态测试. 在创伤,ICU和心血管环境中,TEG显示出有前途的预测结果和指导治疗.
科学领域:
- 麻醉学和重症监护医学
- 血液学 血液学 血液学
背景情况:
- 术后凝血评估对于管理出血和血栓形成风险至关重要.
- 传统的测试 (例如,PT,aPTT) 提供静态的快照,不适合动态的外科变化.
- 粘弹性测试,特别是血栓弹性扫描 (TEG),提供快速,动态的凝血洞察力.
研究的目的:
- 审查有关TEG在各种外科外科环境中的应用的文献.
- 与传统的凝血试验相比,评估TEG的疗效.
主要方法:
- 在PubMed,Medline,Ovid,CINAHL和ClinicalTrials.gov.gov进行了文献搜索.
- 在外科手术前使用TEG的210项研究被检索和分类.
- 研究基于手术设置进行了分析:创伤,产科,骨科,ICU,心血管,移植等.
主要成果:
- 在创伤中,TEG显示有望预测死亡率,高凝结率和出血.
- 在骨科和产科手术中,TEG有助于监测抗凝血,但血栓预测是可疑的.
- 在ICU患者中,TEG在预测败血症,凝血病和停留时间方面表现出实用性.
- 在心血管外科手术中,TEG有效预测了移植中的高凝血和指导治疗.
结论:
- 在不同的外科手术场景中,TEG提供了有价值的动态凝血评估.
- 需要进一步的随机临床试验来标准化TEG在不同环境中的使用.
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