The Role of Thromboelastography and Routine Coagulation Function Test in the Treatment of Liver Failure
Objective To analyze the influence of thromboelastography(TEG)and routine coagulation function test on plasma exchange therapy(PE)and continuous blood purification(CBP)treatment in patients with liver failure.Methods A total of 220 patients with liver failure who were treated in the 910th Hospital of the Joint Logistic Support Force of the People's Liberation Army of China from January 2022 to October 2023 were selected.According to the preoperative comprehensive evaluation results,90 patients treated with PE were included in the control group,and 130 patients treated with CBP were included in the observation group.During the treatment of patients,both groups underwent regular coagulation function tests as a basis for evaluating the effectiveness of the treatment plan.The observation group also underwent TGE evaluation.The application effects of the two detection methods were compared.Results After treatment,after TEG examination,reaction time(R),angle(α),maximum amplitude(MA)and coagulation index(CI)in observation group were(7.8±2.6)min,(44.1±10.4)°,(37.8±7.4)mm and(-6.7±1.5),which were better than before treatment(11.8±3.2)min,(37.2±9.5)°,(34.0±8.5)mm,(-10.6±1.6),and the difference was statistically significant(P＜0.05).After treatment,the prothrombin time(PTA),international normalized ratio(INR),fibrinogen(Fib)and activated partial thromboplastin time(APTT)of the observation group were(19.3±5.3)％,(2.7±1.3)s,(1.1±0.5)g/L,(106.2±40.1)s after routine coagulation function examination.The control group was(46.8±12.0)％,(1.2±0.3)s,(1.4±0.6)g/L and(40.9±14.0)s,all of which were better than before treatment,PTA and Fib in observation group were lower than control group,INR and APTT were longer than control group,the difference was statistically significant(P＜0.05).The PTA and APTT of observation group ≤ 6 h after treatment were(37.0±12.5)％and(76.8±10.5)s,higher than(34.0±10.2)％and(72.0±12.4)s of＞6 h after treatment,the difference was statistically significant(P＜0.05).The R value of observation group≤6 h after treatment was(9.3±3.3)min,α Angle was(38.8±8.2)°,MA was(30.6±13.2)mm,CI was(-8.7±1.8).It was better than(11.4±7.1)min,(34.6±16.4)°,(26.5±12.7)mm,(-10.5±5.8)of＞6 h after treatment,and the difference was statistically significant(P＜0.05).The level of liver function in the observation group after treatment was lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion TEG has a significant value in evaluating the efficacy of CBP in the treatment of liver failure,and the evaluation is more sensitive than that of routine coagulation index.The therapeutic effect and liver function can be improved by monitoring coagulation function during treatment.
liver failurePECBPTEGroutine coagulation function testliver function
NETL
NSTL
万方数据
