在接受胸部手术的轻度低温患者中,温度对凝血功能的影响:血小板造影 (TEG) 与标准测试对比
Shangyi Hui1, Qian Zhang2, Jiaxin Lang1
1Department of Anesthesiology, Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Wang Fu Jing Street, Beijing, 100730, China.
Perioperative medicine (London, England)
|June 12, 2024
概括
轻度低温会在胸部手术期间损害凝血,导致出血增加. 血小板造影 (TEG) 可以有效地检测出这些凝血障碍,与标准测试不同.
科学领域:
- 麻醉学和外科手术期间的医学.
- 血液学 血液学 血液学
- 手术凝血手术的凝血方法
背景情况:
- 轻度低温与胸部手术中过度出血有关.
- 标准的凝血试验无法揭示低温引起的出血背后的机制.
- 了解低温对血液静止的影响对于患者的安全至关重要.
研究的目的:
- 为了研究轻度低温如何损害胸部手术患者的静血功能.
- 为了比较活性和被动变暖组之间的凝血过程,使用血栓凝结学 (TEG).
- 为了确定受到轻度低温影响的特定TEG参数.
主要方法:
- 使用TEG和标准凝血测试对胸部手术患者进行主动和被动加热的血静功能进行比较.
- 从被动变暖组使用TEG在实际核心体温下重新测试血液样本.
- 包括64名符合条件的患者在比较分析中.
主要成果:
- 轻度低温显著损害了凝血,由最大幅度 (MA) 和α角的降低以及延长的凝血时间 (CT) 和K时间证明.
- 与37°C相比,实际核心体温的TEG分析显示出更明显的凝血障碍.
- 患有轻度低温症的患者经历了显著增加的术后发和延迟醒来的时间.
结论:
- 轻度低温严重影响胸部手术患者的凝血功能.
- 在检测低温引起的静血功能障碍方面,TEG优于标准的凝血测试.
- 温度调整的TEG可以在胸部手术中提供更好的静血监测和输血指导,这需要进一步的研究.
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