血栓弹力图评价抗血栓药物疗效与脑出血后下肢深静脉血栓形成的关系研究
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摘要
目的探讨血栓弹力图(TEG)评价抗血栓药物疗效与脑出血后下肢深静脉血栓形成(DVT)的关系。方法选取我院2016年9月至2018年2月收治的脑出血患者150例,随机分为观察组和对照组各75例。对照组术后给予阿司匹林肠溶片治疗,观察组给予低分子肝素钠治疗,比较两组患者的TEG指标,记录治疗期间出血症状及DVT发生情况,分析ADP途径和AA途径血小板抑制率与DVT发生的关系。结果观察组与对照组的AA途径血小板抑制率比较无统计学差异(P>0.05);观察组的ADP途径血小板抑制率高于对照组(P <0.05)。观察组的MA值低于对照组(P <0.05)。观察组治疗期间DVT发生率低于对照组(P <0.05)。根据有无DVT发生分为DVT组和非DVT组, DVT组的AA途径和ADP途径血小板抑制率低于非DVT组(P<0.05)。结论机体对抗血栓药物反应低下是引发DVT的重要原因, TEG监测有助于早期发现疾病,并针对性进行个体化干预。
Objective To explore the thrombelastograph(TEG) in evaluating the relationship between the efficacy of antithrombotic drugs and the formation of deep vein thrombosis of lower extremity after cerebral hemorrhage. Methods 150 cases of patients with cerebral hemorrhage admitted to our hospital from September 2016 to February 2018 were selected and randomly divided into observation group and control group, with 75 cases in each group. The control group was treated aspirin enteric-coated tablets after operation, while the observation group was treated with low molecular weight heparin sodium. The TEG indicators of the two groups were compared, the bleeding symptom of DVT during treatment were recorded, and the relationship between ADP-pathway and AA-pathway platelet inhibition rate and the occurrence of DVT was analyzed. Results No statistical difference was found in the AA-pathway platelet inhibition rate between the observation group and control group(P >0.05). The ADP-pathway platelet inhibition rate of the observation group was higher than that of the control group(P <0.05). The MA value of the observation group was lower than that of the control group(P <0.05). The incidence of DVT during treatment of the observation group was lower than that of the control group(P <0.05). According to the presence or absence of DVT,the patients were divided into DVT group and non-DVT group, and the AA-pathway and ADP-pathway platelet inhibition rates of DVT group were lower than those of non-DVT group(P <0.05). Conclusions Low response to antithrombotic drugs is an important reason of DVT. TEG monitoring is helpful for early detection of diseases and targeted individualized intervention.
Objective To explore the thrombelastograph(TEG) in evaluating the relationship between the efficacy of antithrombotic drugs and the formation of deep vein thrombosis of lower extremity after cerebral hemorrhage. Methods 150 cases of patients with cerebral hemorrhage admitted to our hospital from September 2016 to February 2018 were selected and randomly divided into observation group and control group, with 75 cases in each group. The control group was treated aspirin enteric-coated tablets after operation, while the observation group was treated with low molecular weight heparin sodium. The TEG indicators of the two groups were compared, the bleeding symptom of DVT during treatment were recorded, and the relationship between ADP-pathway and AA-pathway platelet inhibition rate and the occurrence of DVT was analyzed. Results No statistical difference was found in the AA-pathway platelet inhibition rate between the observation group and control group(P >0.05). The ADP-pathway platelet inhibition rate of the observation group was higher than that of the control group(P <0.05). The MA value of the observation group was lower than that of the control group(P <0.05). The incidence of DVT during treatment of the observation group was lower than that of the control group(P <0.05). According to the presence or absence of DVT,the patients were divided into DVT group and non-DVT group, and the AA-pathway and ADP-pathway platelet inhibition rates of DVT group were lower than those of non-DVT group(P <0.05). Conclusions Low response to antithrombotic drugs is an important reason of DVT. TEG monitoring is helpful for early detection of diseases and targeted individualized intervention.
引文
[1]来集富,许文娜,杨光,等.血栓弹力图检测抗血小板药物疗效与下肢动脉腔内治疗后再缺血关系的研究[J].中华普通外科杂志,2018, 33(2):126-129.
[2]李佩佩,王金荣,马耿,等.原发性脑出血后静脉血栓栓塞的预防[J].国际脑血管病杂志, 2016, 24(3):244-247.
[3]张丽巧.血栓弹力图评估重型颅脑创伤术后深静脉血栓的应用价值[J].河北医科大学学报, 2017, 38(10):1148-1152, 1167.
[4]张瑞鹏,田红燕,秦皓,等.血栓弹力图在DVT患者与DVT合并肺栓塞患者中应用研究[J].检验医学与临床, 2017, 14(Z1):260-262.
[5]汪岩,汪鑫,龚西平,等.脑出血合并下肢深静脉血栓形成后抗凝治疗的评价[J].国际外科学杂志, 2017, 44(10):657-660.
[2]李佩佩,王金荣,马耿,等.原发性脑出血后静脉血栓栓塞的预防[J].国际脑血管病杂志, 2016, 24(3):244-247.
[3]张丽巧.血栓弹力图评估重型颅脑创伤术后深静脉血栓的应用价值[J].河北医科大学学报, 2017, 38(10):1148-1152, 1167.
[4]张瑞鹏,田红燕,秦皓,等.血栓弹力图在DVT患者与DVT合并肺栓塞患者中应用研究[J].检验医学与临床, 2017, 14(Z1):260-262.
[5]汪岩,汪鑫,龚西平,等.脑出血合并下肢深静脉血栓形成后抗凝治疗的评价[J].国际外科学杂志, 2017, 44(10):657-660.