Perspectives on Thromboelastography
Perspectives on Thromboelastography
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血栓弹力图的观点
DOI：
10.1055/s-0032-1313629
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发表时间：
1995
影响因子：
5.7
通讯作者：
J. Arcelus
中科院分区：
文献类型：
--
作者：
J. Caprini;C. Traverso;J. Arcelus
对这些误差来源的了解加上严格的方法学，确保了可靠的结果，并避免了一些作者认为的测试局限性。这些所谓的局限性，其实是因为资料不全或经验不足。我们认为，成功使用TEG的关键是在适用的情况下使用该测试。此外，应记住TEG是一项全球凝血试验，因此应在适用时评价是否需要额外的止血试验（图3）。本文综述了TEG的主要应用：（1）高凝状态的检测，尤其是术后和恶性肿瘤患者;（2）肝素静脉给药患者的管理;（3）肝移植术中凝血状态的监测;（4）体外循环中凝血状态的监测和管理;（5）肝移植术后凝血状态的监测。和（5）诊断和治疗血液功能障碍，特别是血友病。华法林给药患者的管理，以及在几种外科手术中监测皮下肝素预防的调整，可能属于此列表，但需要进一步的研究来证实这些作用。由经验丰富的人使用，TEG是一种有价值的止血测试，其未来已经存在。
The knowledge of these sources of error together with strict methodology assure reliable results and avoid what some authors consider limitations of the test. These so-called limitations are actually due to incomplete information or insufficient experience. It is our opinion that the key for success when using TEG is to use the test in those cases for which it has been indicated. Also, the fact that TEG is a global test of coagulation should be kept in mind and therefore the need for additional hemostatic tests should be evaluated when applicable (Fig.3). According to this review, the established applications of TEG are as follows: (1) detection of hypercoagulable states, particularly in the postoperative period and for patients with malignancies; (2) management of patients who are administered intravenous heparin; (3) monitoring the coagulation state during liver transplantation; (4) monitoring the coagulation state and management of patients during cardiopulmonary bypass; and (5) diagnosis and treatment of hematologic dysfunctions, particularly hemophilia. Management of patients under warfarin administration, as well as monitoring of the adjustment of subcutaneous heparin prophylaxis in several surgical procedures, should probably belong to this list, but further studies are needed to confirm these roles. Used by experienced hands, TEG is a valuable hemostatic test, the future of which is already present.