Clinical value of thromboelastography in monitoring coagulation function change in patients with severe lever cirrhosis gastrointestinal bleeding
10.3969/j.issn.1671-8348.2024.18.003
- VernacularTitle:血栓弹力图监测重症肝硬化消化道出血患者凝血功能变化的临床价值
- Author:
Rong HE
1
;
Minsheng WU
;
Shengkui CHEN
;
Pinjing LIU
;
Jun LI
;
Yudan PAN
;
Bingquan HU
Author Information
1. 广西中医药大学附属瑞康医院重症医学科,南宁 530000
- Keywords:
liver cirrhosis;
acute upper gastrointestinal hemorrhage;
coagulation function;
thromboelastography;
blood transfusion
- From:
Chongqing Medicine
2024;53(18):2735-2738,2743
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical value of thromboelastography (TEG) in monitoring the coagulation function change after plasma supplementation in the patients with severe liver cirrhosis diges-tive tract hemorrhage.Methods A total of 48 patients with high risk and extreme high risk liver cirrhosis a-cute upper digestive hemorrhage receiving the treatment in ICU of this hospital from February 2020 to March 2023 were selected as the study subjects.After plasma infusion with the dose of 10 mL/kg,the coagulation function status was detected.The patients were divided into the TEG group (n=20) and the control group (n=28) according to different detection modes of coagulation function.The TEG group simultaneously detec-ted TEG and traditional coagulation function detection,while the control group only conducted the traditional coagulation detection.TEG and coagulation function detection indicators after the infusion of plasma were compared between the two groups.The plasma infusion amounts at 24 h after admitting in ICU were recorded and the control status of digestive tract hemorrhage was evaluated.Results The R value in the TEG group was (8.02±6.09)min,the K vale was 2.5(1.3,5.0)min,the coagulation comprehensive index (CI) was-4.70±6.29,the maximal shear stress coefficient (MA) was 50.35±18.84,LY30 was 0.The Pearson corre-lation analysis showed that MA was positively correlated with FIB and PLT (r=0.470,0.526,P<0.05),and the other indexes had no correlation.Compared with the control group,the plasma infusion amounts in the TEG group was more[(419.00±143.18)mL vs. (400.00±137.54)mL],the digestive tract hemorrhage con-trol rate was higher[75.00％(15/20) vs. 53.57％(15/28)],but the differences were not statistically signifi-cant (P>0.05).The multiple linear regression was MA=-3.427+11.200×Ln(PLT)+10.230×Ln(FIB).Con-clusion In the patients with severe lever cirrhosis acute upper gastrointestinal bleeding,TEG could earlier find the co-agulation function improvement situation after plasma supplementation than the traditional coagulation detection.
