Clinical Value Of Thromboelastography In The Evaluation Of Coagulation Dysfunction In Patients With Multiple Injuries

Objective:To explore the significance of thromboelastography in the evaluation of patients with multiple injuries and coagulopathy.Methods:Eighty-two patients with multiple injuries who met the requirements admitted to the emergency department of the First Affiliated Hospital of Nanchang University from January 2020 to January 2021 were selected as the experimental group.The observation group was divided into mild group and severe group according to whether the trauma severity score(ISS score)was greater than 16,and 41 normal patients admitted at the same time were selected as the control group.Response time(R),blood clot formation time(K),blood clot formation rate(a Angle),and prothrombin time(PT),activated partial thrombin time(APTT),platelet count(PLT),fibrinogen(FBG),and International standardized ratio(INR)of the enrolled patients on admission were collected.Statistical analysis was performed to compare the differences of conventional coagulation function indexes and thrombologram indexes in the data.Results:PT,APTT,FBG and INR indexes in the experimental group were significa-ntly higher than those in the control group,and the differences were statistically significant(P < 0.05).The PLT index of observation group was significantly lower than that of control group,and the difference was statistically significant(P < 0.05).In the index of thrombologram,the control group: R(6.32±1.44)min,K(2.11 ±0.32)min,a Angle(60.38±4.32)°;Experimental group: R(10.38±1.67)min,K(3.67±0.41)min,a Angle(46.72±4.12)°,R(t= 11.789,P=0.001)min,K(t=19.206,P=0.001)min,a Angle(t=43.269,P=0.001)° in the two groups.The results showed that R and K in the observation group were significantly higher than that in the control group,and Angle a was significantly lower than that in the control group,with statistical significance(P < 0.05).Correlation analysis between thromboelasticity chart and conventional coagulation function index showed that the time of clot formation(K)was negatively correlated with FBG and PLT(P < 0.05),and the clot formation rate(a Angle)was positively correlated with FBG and PLT(P < 0.05).In the experimental group comparison: Mild group: R(9.75±1.51)min,K(3.20±1.41)min,a Angle(48.13 ± 11.96)°;In the severe group,R(11.06±1.41)min,K(3.82±1.39)min,a Angle(40.41±12.42)°,and R(P= 0.019)min,K(P=0.001)min,a Angle(P=0.001)° in the two groups.The results showed that there was a significant difference between the two groups(P < 0.05).Conclusion:The application of thrombologram in different scores of multiple injuries with coagulation dysfunction can provide evidence for clinicians and has certain clinical value.