国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2014年
4期
346-350
,共5页
刘宿%唐小唪%吴朋%葛衡江
劉宿%唐小唪%吳朋%葛衡江
류숙%당소봉%오붕%갈형강
急性创伤性凝血病%血栓弹性描记图%快速血栓弹性描记图
急性創傷性凝血病%血栓彈性描記圖%快速血栓彈性描記圖
급성창상성응혈병%혈전탄성묘기도%쾌속혈전탄성묘기도
Acute traumatic coagulopathy%Thromb-elastography%Rapid thromb-elastography
背景 严重创伤所致的凝血功能紊乱可使出血难以控制,是创伤早期死亡的主要原因;即或一些患者已接受了外科止血,仍可能死于难治性凝血功能障碍.目前创伤引起的凝血功能障碍仍是改善严重创伤患者预后的难题之一. 目的 评估血栓弹性描记图(thromb-elastography,TEG)尤其是快速TEG (rapid thromb-elastography,r-TEG)在刨伤医学中应用的优势. 内容 传统的凝血试验不能全面和快速地评估机体凝血纤溶过程及血小板功能,而黏弹性止血试验技术弥补了此不足.通过在创伤动物模型和创伤患者中应用r-TEG,证实其能在较短时间内评价患者的凝血、纤溶及血小板功能状况,预测患者的输血需求. 趋势 TEG引入创伤医学通过r-TEG测定已得到了发展,其参数能尽早判断创伤性凝血病的存在以进行早期目标导向凝血治疗.
揹景 嚴重創傷所緻的凝血功能紊亂可使齣血難以控製,是創傷早期死亡的主要原因;即或一些患者已接受瞭外科止血,仍可能死于難治性凝血功能障礙.目前創傷引起的凝血功能障礙仍是改善嚴重創傷患者預後的難題之一. 目的 評估血栓彈性描記圖(thromb-elastography,TEG)尤其是快速TEG (rapid thromb-elastography,r-TEG)在鑤傷醫學中應用的優勢. 內容 傳統的凝血試驗不能全麵和快速地評估機體凝血纖溶過程及血小闆功能,而黏彈性止血試驗技術瀰補瞭此不足.通過在創傷動物模型和創傷患者中應用r-TEG,證實其能在較短時間內評價患者的凝血、纖溶及血小闆功能狀況,預測患者的輸血需求. 趨勢 TEG引入創傷醫學通過r-TEG測定已得到瞭髮展,其參數能儘早判斷創傷性凝血病的存在以進行早期目標導嚮凝血治療.
배경 엄중창상소치적응혈공능문란가사출혈난이공제,시창상조기사망적주요원인;즉혹일사환자이접수료외과지혈,잉가능사우난치성응혈공능장애.목전창상인기적응혈공능장애잉시개선엄중창상환자예후적난제지일. 목적 평고혈전탄성묘기도(thromb-elastography,TEG)우기시쾌속TEG (rapid thromb-elastography,r-TEG)재포상의학중응용적우세. 내용 전통적응혈시험불능전면화쾌속지평고궤체응혈섬용과정급혈소판공능,이점탄성지혈시험기술미보료차불족.통과재창상동물모형화창상환자중응용r-TEG,증실기능재교단시간내평개환자적응혈、섬용급혈소판공능상황,예측환자적수혈수구. 추세 TEG인입창상의학통과r-TEG측정이득도료발전,기삼수능진조판단창상성응혈병적존재이진행조기목표도향응혈치료.
Background It is difficult to control bleeding of coagulopathy induced by severe trauma.Coagulopathy is the main cause of death in the early phase of trauma.Some patients may died of refractory coagulopathy,even if they had received surgery to control bleeding.Trauma-induced coagulopathy is still one of the problems to improve the prognosis of patients with severe trauma.Objective The advantage of application of thromb-elastography (TEG) especially rapid thromb-elastography (r-TEG) test for trauma was evaluated.Content Traditional coagulation tests can not evaluate status of coagulation,fibrinolysis and platelet comprehensively and quickly during trauma,but viscoelastic haemostasis assays make up for this deficiency.Application of r-TEG in traumatic animal models and traumatic patients was confirmed which can evaluate the status of coagulation,fibrinolysis and platelet rapidly,predict transfusion needs of patients.Trend TEG has been developed by rapid TEG in traumatic medicine.The parameters can identify the acute traumatic coagulopathy as soon as possible,guide the early goal-directed coagulation therapy.