术后常规凝血检测与肝脏主要切除的血栓结晶造影的评估 - 一个单臂,前性,干预性试验 (PORTAL试验)
Reshma Ambulkar1, Vignesh Baskar2, Shraddha Patkar3
1Department of Anaesthesiology, Critical Care and Pain, ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Navi-Mumbai, Maharashtra, India.
Indian journal of anaesthesia
|February 12, 2024
概括
国际规范化比率 (INR) 在大肝切除后高估了凝血病. 输血策略指导的血小板造影 (TEG) 减少了这些患者的血液成分使用.
科学领域:
- 肝胆道手术是肝胆道的手术.
- 凝血诊断仪器 凝血诊断仪器
- 输血药物 输血药物 输血药物
背景情况:
- 主要的肝切除会破坏凝血因子的合成.
- 像PT-INR这样的常规凝血测试可能无法完全捕捉外科手术期间的凝血病.
- 血小板造影 (TEG) 提供了更全面的血液静止的评估.
研究的目的:
- 为了评估大肝切除 (≥3段) 后的术后凝血变化.
- 将常规凝血测试与TEG发现进行比较.
- 评估TEG引导的输血策略对血液成分使用的影响.
主要方法:
- 一项前性,单臂的干预性研究,对25名接受肝切除的大型切除的患者进行.
- 在多个外科手术前的时间点对常规凝血试验和TEG进行连续监测.
- 斯皮尔曼等级对应关系用于分析凝血试验之间的关系.
主要成果:
- 输血红素时间-国际规范化比率 (PT-INR) 在56%的手术内和术后患者中升高.
- 在整个外科手术期间,所有患者的TEG参数保持正常.
- 在TEG引导的输血策略中,分别在4,11和10名患者的手术内,手术后立即和48小时后避免了输血.
结论:
- PT-INR高估了经过肝切除的大型切除的患者的凝血病.
- TEG可以更准确地评估凝血状态.
- 以TEG为指导的输血策略可以显著减少血液成分需求.
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