摘要
凝血功能检测在外科手术中的应用日益受到关注，本研究旨在评估其在围手术期管理中的临床价值。随着外科手术复杂性的增加，术中出血和血栓风险成为重要挑战，而传统凝血指标难以全面反映患者的实际凝血状态。为此，本研究采用前瞻性队列设计，纳入300例外科手术患者，通过常规凝血检测（如PT、APTT）与新型功能性检测技术（如TEG、 ROTEM）的联合应用，分析其对术中出血量、输血需求及术后并发症的预测能力。结果显示，功能性凝血检测能够更准确地评估患者的凝血平衡状态，并显著提高术中输血决策的精准性，降低术后并发症发生率。与传统方法相比，新型检测手段具有更高的敏感性和特异性，尤其在高危患者群体中表现出显著优势。本研究的创新点在于首次系统比较了多种凝血检测技术在外科手术中的应用效果，为优化围手术期管理提供了理论依据和技术支持，同时强调个体化凝血监测的重要性，以改善患者预后并降低医疗成本。关键词：凝血功能检测；围手术期管理；功能性检测技术；术中输血决策；术后并发症
Evaluation of Coagulation Function Testing in Surgical Procedures
Abstract
The application of coagulation function testing in surgical procedures has garnered increasing attention, and this study aims to evaluate its clinical value in perioperative management. As the complexity of surgical interventions rises, intraoperative bleeding and thrombotic risks have become critical challenges, while traditional coagulation indices often fail to comprehensively reflect a patient's actual coagulation status. To address this issue, this study employed a prospective cohort design, enrolling 300 surgical patients, and analyzed the predictive capabilities of combined conventional coagulation tests (such as PT and APTT) with novel functional testing technologies (such as TEG and ROTEM) regarding intraoperative blood loss, transfusion requirements, and postoperative complications. The results demonstrated that functional coagulation testing could more accurately assess a patient’s coagulation balance state, significantly enhancing the precision of intraoperative transfusion decisions and reducing the incidence of postoperative complications. Compared with traditional methods, the novel testing approaches exhibited higher sensitivity and specificity, particularly showing significant advantages in high-risk patient populations. An innovative aspect of this study lies in its first systematic comparison of multiple coagulation testing techniques applied in surgical settings, providing theoretical evidence and technical support for optimizing perioperative management. Furthermore, it underscores the importance of individualized coagulation monitoring to improve patient outcomes and reduce healthcare costs.
Keywords: Coagulation Function Test; Perioperative Management; Functional Testing Technology; Intraoperative Blood Transfusion Decision; Postoperative Complications
目录
摘要 I
Abstract II
引言 1
1 凝血功能检测的基本原理与方法 1
1.1 凝血功能检测的生物学基础 1
1.2 常用凝血功能检测技术概述 2
1.3 检测技术的选择与优化 2
2 外科手术中凝血功能的风险评估 3
2.1 手术类型与凝血风险特征 3
2.2 术前凝血功能状态分析 3
2.3 风险评估模型的应用价值 4
3 凝血功能检测在术中的实时监测 4
3.1 术中凝血功能变化规律 4
3.2 实时监测技术的临床应用 5
3.3 监测数据对术中决策的支持 5
4 凝血功能检测结果的术后管理 5
4.1 术后凝血功能异常的表现 5
4.2 检测结果指导术后干预策略 6
4.3 长期随访与预后评估 6
结论 7
参考文献 8
致谢 9
