CAJ | 학술논문

目的：探讨血栓弹力图（T EG ）在蛛网膜下腔阻滞麻醉剖宫产中对产妇凝血功能的影响。方法选取2011年1月至2013年12月在新乐市医院产科行剖宫产的50例产妇为研究对象，分别于麻醉前、麻醉后1 h采集产妇手部和足部静脉血，采用T EG对产妇麻醉前、麻醉后凝血功能进行评价。结果比较蛛网膜下腔阻滞麻醉前、蛛网膜下腔阻滞麻醉后1 h产妇手部静脉血TEG各参数值，差异有统计学意义（P＜0．01）；蛛网膜下腔阻滞麻醉后1 h产妇手部静脉血TEG参数反应时间（R）、血凝块形成时间（K）数值低于麻醉前，差异有统计学意义（P＜0．01）；蛛网膜下腔阻滞麻醉后1 h产妇手部静脉血T EG参数α角、最大振幅（M A ）值、凝血指数（CI）数值高于麻醉前，差异有统计学意义（P＜0．01）；蛛网膜下腔阻滞麻醉前、蛛网膜下腔阻滞麻醉后1 h产妇足部静脉血TEG参数R、K、MA值、CI数值，差异无统计学意义（P＞0．05）；蛛网膜下腔阻滞麻醉后1 h产妇足部静脉血 TEG参数α角数值高于麻醉前，差异有统计学意义（P＜0．01）。结论蛛网膜下腔阻滞麻醉下行剖宫产产妇采用不同血液标本进行检测T EG参数值在麻醉前、麻醉后变化较大；采用T EG评价蛛网膜下腔阻滞麻醉下行剖宫产产妇凝血状况时，血液标本采自于上肢静脉血时，T EG参数值变化较大；血液标本采自于下肢静脉血时，T EG参数值可无显著变化；蛛网膜下腔阻滞麻醉对行剖宫产产妇上肢静脉血和下肢静脉血T EG检测参数值的影响存在较大差异。
목적：탐토혈전탄력도（T EG ）재주망막하강조체마취부궁산중대산부응혈공능적영향。방법선취2011년1월지2013년12월재신악시의원산과행부궁산적50례산부위연구대상，분별우마취전、마취후1 h채집산부수부화족부정맥혈，채용T EG대산부마취전、마취후응혈공능진행평개。결과비교주망막하강조체마취전、주망막하강조체마취후1 h산부수부정맥혈TEG각삼수치，차이유통계학의의（P＜0．01）；주망막하강조체마취후1 h산부수부정맥혈TEG삼수반응시간（R）、혈응괴형성시간（K）수치저우마취전，차이유통계학의의（P＜0．01）；주망막하강조체마취후1 h산부수부정맥혈T EG삼수α각、최대진폭（M A ）치、응혈지수（CI）수치고우마취전，차이유통계학의의（P＜0．01）；주망막하강조체마취전、주망막하강조체마취후1 h산부족부정맥혈TEG삼수R、K、MA치、CI수치，차이무통계학의의（P＞0．05）；주망막하강조체마취후1 h산부족부정맥혈 TEG삼수α각수치고우마취전，차이유통계학의의（P＜0．01）。결론주망막하강조체마취하행부궁산산부채용불동혈액표본진행검측T EG삼수치재마취전、마취후변화교대；채용T EG평개주망막하강조체마취하행부궁산산부응혈상황시，혈액표본채자우상지정맥혈시，T EG삼수치변화교대；혈액표본채자우하지정맥혈시，T EG삼수치가무현저변화；주망막하강조체마취대행부궁산산부상지정맥혈화하지정맥혈T EG검측삼수치적영향존재교대차이。
Objective To study the evaluation of thromboelastography detecting the effect of spinal anesthesia on maternal blood coagulation function in parturients undergoing cesarean section .Methods 50 pregnant women un‐dergoing cesarean section in the obstetrics and gynecology department of Xinle Municipal Hospital from January 2011 to December 2013 were selected as the research subjects .The venous blood was collected from the hand and foot of the subjects before anesthesia and at 1 h after anesthesia .TEG was adopted to evaluate the coagulation function be‐fore and after anesthesia .Results The various TEG parameters of parturient′ s hand venous blood had statistical differences between before subarachnoid space block anesthesia and at 1 h after subarachnoid space block anesthesia;the TEG parameter R and K values at 1 h after subarachnoid space block anesthesia were lower than those before an‐esthesia ,the differences were statistically significant(P<0 .01) ,theαangle ,MA and CI values of hand venous blood at 1 h after anesthesia were higher than those before anesthesia ,the differences were statistically significant(P<0 .01);the TEG parameter R ,K ,MA and CI values in the foot venous blood before anesthesia and at 1 h after anes‐thesia had no statistical differences(P>0 .05) ,while theαangle values at 1 h after anesthesia was higher than that before anesthesia ,the difference was statistically significant(P<0 .01) .Conclusion The TEG parameters values de‐tected in different blood samples from the parturients with cesarean section under subarachnoid space block anesthe‐sia have larger differences between before and after anesthesia;by adopting TEG for evaluating the coagulation status in the parturients with cesarean section under subarachnoid space block anesthesia ,if the blood sample is collected from the upper limb venous blood ,the TEG parameters values have larger change;if the blood sample is collected from the lower limb venous blood ,the TEG parameters values would have no significant change;the influence of sub‐arachnoid space block anesthesia on the parameters values of T EG detection in the upper limb venous blood and the lower limb venous blood of the parturients with cesarean section has larger differences .