Application Of Thromboelastography In The Treatment Of Obstetric Hemorrhagic Diseases

Objective:To evaluate the value of thromboelastography(TEG)in the treatment of postpartum hemorrhage in cesarean section in patients with hemorrhagic disease in the maternity department,and to explore whether TEG parameters can guide clinical blood transfusion in the post-production hemorrhage,and whether it can predict cesarean section.Bleeding and the value of assessing the effects of blood transfusions.Methods:We collected 60 patients with elective cesarean section who were treated with obstetrics in our hospital from January to December 2018.The patients were included in the bleeding group(combined placenta previa,placental abruption or preeclampsia(severe)and other typical obstetric hemorrhagic diseases).60 cases of cesarean section women who did not see the above complications during the same period were used as the control group.Before the operation,the two groups of pregnant women were drawn blood to check blood routine,coagulation function and TEG examination;intraoperative hemodynamics,output(urine volume,blood loss)and intake(colloid or blood products)were monitored;If bleeding >1000ml,re-monitor blood routine,coagulation function and TEG index.If blood transfusion is needed during surgery,TEG is reviewed after transfusion.Postoperatively,the blood routine,TEG,coagulation function and postoperative bleeding volume of the two groups were reviewed.Result:1 There were no statistically significant differences in preoperative blood routine,coagulation function and TEG parameters between the two groups.2 The preoperative R value of the bleeding group was positively correlated with FIB,PT and TT and was significantly correlated.The K value is negatively correlated with Fig,and the Angle angle is positively related to FIB.The MA value is positively correlated with PLT.The CI value is negatively correlated with FIB.LY30 is negatively related to FIB The R value of the control group was positively correlated with Fig,PT and TT,and significantly correlated with PT and TT.The K value is negatively correlated with Fig and is significantly negatively correlated.Both R and K values were positively correlated with Hb and negatively correlated with PLT;MA,CI and FIB were significantly negatively correlated;CI was negatively correlated with Hb.3 R value,K value and LY30 were significantly negatively correlated with FIB and significantly positively correlated with D-II mer;K value was significantly positively correlated with blood loss;Angle angle and CI value were significantly positively correlated with Fig and D-II Body,PT,and TT were significantly negatively correlated and negatively correlated with the amount of bleeding.The MA value was significantly positively correlated with PLT;the CI value was significantly negatively correlated with PT,TT,and PLT,and negatively correlated with the amount of bleeding.LY30 is negatively correlated with PLT.The parameters related to the amount of bleeding are: K value(r = 0.412,P = 0.004**),Angle angle,and CI value are related to the amount of bleeding.Conclusion:1 Bleeding group maternal TEG parameters are related to blood routine test,coagulation image examination.2 preoperative Angle angle,K value,CI value showed a good correlation with the amount of bleeding in cesarean section of obstetric hemorrhagic disease,can be used to predict postpartum hemorrhage in obstetric hemorrhagic disease,K value prolonged,Angle angle The reduction,the CI value is reduced,that is,the greater the amount of bleeding,the worse the maternal outcome.