本文選題：非體外循環(huán)冠脈搭橋 + TEG　； 參考：《首都醫(yī)科大學》2014年碩士論文

【摘要】：目的 研究非體外冠脈搭橋術(shù)中血栓彈力圖(TEG)和sonoclot凝血儀監(jiān)測指標的相關(guān)性，同時也研究非體外冠脈搭橋術(shù)中凝血功能的變化規(guī)律。 方法 收集首都醫(yī)科大學附屬北京朝陽醫(yī)院心外科擇期行不停跳冠脈搭橋手術(shù)的患者30例，分別于麻醉誘導后(T1)、給予魚精蛋白后10min(T2)、關(guān)胸縫皮結(jié)束即刻(T3)三個時點分別采集靜脈血檢測，記錄凝血指標：硅燥土激活的全血血栓彈性描記圖(thrombelastography，TEG)，指標包括R值、K值、Alpha角和MA值；玻璃珠激活的全血SCA，指標包括ACT、CR和PF值。 結(jié)果1：R與gbACT成正相關(guān)，r=0.752，p0.01，CR與K成負相關(guān)，r=-0.734,p0.01，CR與Alpha角成正相關(guān)，r=0.659，p0.01，MA與PF成正相關(guān)，r=0.497，p0.01。2，，SCA顯示：與術(shù)前相比，術(shù)后gbACT明顯延長(P0.05)，CR、PF明顯降低（P0.05)；TEG顯示：與術(shù)前相比，R明顯延長(P0.05)，K，Alpha角差異無統(tǒng)計學意義，MA顯著降低(P0.05)。 結(jié)論 1:OPCAB手術(shù)導致患者凝血功能障礙，體現(xiàn)為gbACT延長，CR下降，PF降低。 2：SCA與TEG的凝血指標中R與gbACT，CR與K，CR與Alpha角，PF與MA四組指標均有良好的相關(guān)性。 3：和SCA相比，TEG基本準確反映OPCABG患者凝血狀態(tài)。但其準確性、穩(wěn)定性等方面還需要在今后臨床上進行驗證。
[Abstract]:PurposeTo study the correlation between thromboelastogram (TEG) and sonoclot coagulation monitoring index in non-external coronary artery bypass grafting, and to study the change of coagulation function in non-external coronary artery bypass grafting.MethodA total of 30 patients undergoing elective coronary artery bypass surgery in Beijing Chaoyang Hospital affiliated to Capital Medical University were selected. Venous blood was collected at three time points, namely T1 after anesthesia induction, protamine 10 min after administration of protamine, and T3 at the end of closure of thoracic suture skin.The indexes of coagulation were as follows: thromboelastic thrombography activated by silica dry soil, including R value, K value, Alpha angle and MA value, and vitreous bead activated whole blood SCA, including ACTA CR and PF values.Results 1: r was positively correlated with gbACT 0.752p0.01A, CR was negatively correlated with K r-0.734p0.01A, CR was positively correlated with Alpha angle 0.659p 0.01A was positively correlated with PF 0.497p 0.01.2SCA showed that, compared with pre-operation, the ratio of CR to Alpha was 0.497p 0.01.2SCA showed that there was no significant correlation between CR and Alpha, and the correlation between CR and Alpha was 0.497p 0.01.2SCA.After operation, gbACT was significantly prolonged (P 0.05) and the PF was significantly decreased (P 0.05). The results showed that there was no significant difference in the angle of K 偽 between the two groups compared with that before operation. However, MA was significantly lower than that before operation (P 0.05).ConclusionCoagulation dysfunction was caused by 1:OPCAB operation, which showed that gbACT prolonged CR decreased and PF decreased.There was a good correlation between R and gbACTCR and Alpha angle PF and MA in the coagulation index of 2:SCA and TEG.3: compared with SCA, the clotting state of OPCABG patients was basically reflected accurately.However, its accuracy, stability and other aspects need to be verified in the future.
【學位授予單位】：首都醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R614

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相關(guān)期刊論文 前1條

1 武宙陽;Sonoclot凝血與血小板功能分析儀在體外循環(huán)中的應(yīng)用[J];國外醫(yī)學.麻醉學與復蘇分冊;2003年01期

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