上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

血栓弹力图在监测重度子前期孕妇凝血功能障碍中的意义

毛亚静1，杨祖菁2   

  1. 1.上海交通大学 新华临床医学院， 2.上海交通大学 医学院附属新华医院妇产科， 上海 200092
  • 出版日期:2013-12-28 发布日期:2014-01-02
  • 通讯作者: 杨祖菁, 电子信箱: yzujing@sohu.com。
  • 作者简介:毛亚静（1987—）， 女， 住院医师， 硕士生; 电子信箱: huangdumaomao@sina.com。

Significance of thromboelastography in the monitoring of maternal coagulation disorders in preeclampsia

MAO Ya-jing1, YANG Zu-jing2   

  1. 1.School of Xinhua Clinical Medicine, Shanghai Jiaotong University, Shanghai 200092, China; 2.Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
  • Online:2013-12-28 Published:2014-01-02

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摘要：

目的 探讨血栓弹力图在观察重度子前期患者凝血功能中的意义及在监测围生期出血风险中的价值。方法 将重度子前期孕妇58例分为重度子前期组（血小板计数≥100×109/L）（n=44）和重度子前期并发血小板减少症组（血小板计数＜100×109/L）（n=14）；以正常妊娠晚期孕妇33例作为对照组。分别进行血栓弹力图（TEG）、血常规及凝血试验检测。结果 重度子前期组TEG各项参数与对照组比较，差异均无统计学意义（P>0.05）；重度子前期并发血小板减少症组患者的TEG参数与对照组及重度子前期组比较，α角减小，最大振幅(MA值) 缩短、凝血综合指数(CI值)减小，差异均有统计学意义（P<0.05）。各组TEG中MA值和CI值均与血小板计数呈线性相关（P<0.05）。结论 TEG可作为一项监测重度子前期并发血小板减少症孕妇凝血功能状况的有效指标，其血液呈低凝状态，出血风险增加。

关键词: 血栓弹力图, 子前期, 血小板减少, 出血

Abstract:

Objective To study the values of thromboelastography (TEG) in detection of coagulation function and obstetric hemorrhage risk in severe preeclampsia patients. Methods Fifty-eight patients were divided into severe preeclampsia group (platelet count≥100×109/L）（n=44） and severe preeclampsia with thrombocytopenia group （platelet count＜100×109/L）（n=14）according to platelet count in time of admission. And 33 normal late pregnant women were randomly selected as control group. All patients and pregnant women underwent TEG, blood routine examination, and coagulation test. Results There was no significant differences among TEG parameters between severe preeclampsia group and control group （P>0.05）. But compared to the two groups, in severe preeclampsia with thrombocytopenia group, there were smaller α angle, shorter MA value, and lower CI value （P＜0.05）. In each group, MA value and the CI value were positively correlated with the platelet count （P＜0.05）. Conclusion TEG may be used as a useful indicator to observe the state of blood coagulation of preeclampsia combined with thrombocytopenia, in which the status was low with high risk of bleeding.

Key words: thromboelastography, preeclampsia, thrombocytopenia, bleeding