The Value Of Thrombelastography In The Diagnosis And Treatment Of Early-onset Severe Preeclampsia

Objective:This paper aims to explore the role of Thrombelastography(TEG)in the analysis of the coagulation function of pregnant women in early-onset severe preeclampsia patient,comparing its differences with conventional coagulation index analysis and its significance in guiding the anticoagulant therapy for pregnant women in early-onset severe preeclampsia,to provide basis for diagnosis and treatment of early-onset severe preeclampsia complications.Material and Method:This study used case-control studies,from January 2015to May 2017,110 pregnant women with early-onset of severe pre-eclampsia in the obstetrical hospital of our hospital were collected for the research group.Divide it into three groups by platelet count:Group A:68 cases,platelet number of>100*10~9/L;Group B:30 cases,platelet number of(70~100)*10~9/L;Group C:12 cases,platelet number of<70*109/L;Among them,group A was divided into 34 cases of low molecular heparin sodium treatment group and 34 cases of non-treatment group.Control group:randomly selected 100 cases of normal pregnant women in hospital from June 2015 to May 2017 in our hospital.All the research group carried out routine coagulation tests,TEG detection and liver kidney function tests in admission,group A rechecked the above indicators after2-10 days after standard treatment.The control group was tested for routine coagulation tests,TEG detection and liver kidney function during the 20-34 weeks of pregnancy.?Compare the clinical data of the research group and the control group.?The difference of routine coagulation indexes,PT,APTT,TT,Fib,D-,and AT-III between each research group and control group was compared between the two groups.?The quantitative indexes of TEG,R time,K time,alpha angle,MA value and CI value of each group were compared between the research group and the control group.?The correlation between TEG parameters and routine coagulation tests of the study group and the control group was analyzed.?The changes of routine coagulation indexes and TEG indexes before and after treatment in group A were observed and compared.Results:?Analysis of routine coagulation indexes between the research group and the control group:group A was compared to the control group:PT?APTT?TT significantly shortened,Fib significantly increase(P<0.05);group B was compared to the control group:PT?APTT?TT?Fib differences were not significant;group C was compared to the control group:PT?APTT?TT significantly prolonged,Fib significantly decrease(P<0.05);The differences of D-D and AT-III between the groups were statistically significant.?TEG parameter analysis between the group and the control group:group A was compared to the control group:R and K significantly decrease,?angle?MA?CI significantly increase(P<0.05);group B was compared to the control group:R and K showed a rising tendency,but P>0.05,?angle?MA?CI significantly decrease(P<0.05);group C was compared to the control group:R and K significantly increase,?angle?MA?CI significantly decrease(P<0.05);?Correlation analysis shows between R and PT?APTT,K and Fib,?angle and Fib,MA and PLT,CI and Fib?PLT are linearly dependent,But the correlation is not high.?After treatment of low molecular heparin:TT significantly prolong,D-D significantly decrease,R significantly prolong,MA significantly decrease,the other indexes was no significant difference.Conclusions:The blood coagulation of early-onset severe preeclampsia patients in different stages were significantly different.It could be high coagulation,it could be low condensation.The routine coagulation index cannot be accurately reflected in time,and it is necessary to use TEG to accurately monitor the patient's coagulant appearance.It has a certain correlation between TEG and routine coagulation indexes.But the correlation is not high.The response to coagulation disorder is different,and the optimal combination should be based on patient condition.The treatment of low molecular heparin treatment has normalised some of the conventional coagulation indicators and TEG parameters,and alleviates the high coagulation state to some extent.