The Evalution Of Thrombelastogram In Assessing The Coagulation Function Of Cerebral Hemorrhage Patients During Perioperative Period

Purpose: This research mainly focus on analyzing the coagulation state of cerebral hemorrhage patients during the perioperative period.To explore the utility of thrombelastogram in assessing the coagulation function of cerebral hemorrhage patients during the perioperative period.Methods: Patients who were admitted into No.251 hospital of PLA from January in the year of 2016 to October in the year of 2017,diagnosized as cerebral hemorrhage and received emergent operation were collected.40 cases were allocated into craniotomy group.40 other patients who were diagnosized as cerebral hemorrhage without necessity of operation during the same period of time were allocated into conservative group.The changes of the items of thrombelastogram in the two groups were observed.Inclusion criteria: 1.Admitted into hospital in less than 6 hours after the attack of the disease,clearly diagnosized as cerebral hemorrhage by head CT,and operation was processed in less than 2 hours after the admittion of the patient in observation group.2.No gender limitation,ages ranging from 20 to 70 years old,informed consent form was signed.Exclusion criteria: 1.Have a history of using anti-coagulation drug or receiving anti-coagulation treatment before the attack of the disease,2.Give up the treatment during the hospitalization or quit for other reasons.3.During the time of menstruation.4.Suffered from hematological disease or related inherited disease,the coagulation state is different from normal.5.suffered from other serious disease that may impact the prognosis of the patient.6.SAH,acompanyed by AVM,aneurysm,or moyamoya disease.7.tumor apoplexy.8.Cerebral hemorrhage after massive cerebral infarction.9.Cerebral hemorrhage caused by brain trauma.10.Transfusion during the operation.Observation itemscoagulation response time(R): normal in 3-8min.2.blood clot formation time(K):normal in 1-3min.3.coagulation angle(?):normal between 55-78.4.maximum blood clot strength(MA): normal between 51-75mm;5.Coagulation comprehensive index(CI): normal between-3 to 3.Statistic methods: statistical analysis was performed with the program of SPSS22.0,measurement data was described by(x ±S),student`s t-test was used when the Mean of the two groups compared,the differences was considered significant when P<0.05.Results:1.The emergent results: the results of the thrombelastograms revealed a slightly hypercoagulation status in both groups,there was no significant differences between the two groups(P>0.05).2.The 24-hour results: the results of the thrombelastograms revealed a hypocoagulation status in both groups,and there was significant differences between two groups(P<0.05).3.The 72-hour results: the results of conservative group were almost normal,which mean the recovery of coagulation function.Whereas,the results of craniotomy group revealed a hypocoagulation status in patients,the differences of the results between the two groups were significant(P<0.05)Conclusion: The results of the thrombelastogram revealed obvious disorders of coagulation function in cerebral hemorrhage patients,the coagulation state before the operation or in the first day after the operation or in the third day after the operation were all different,the disorder of the coagulation was the most serious in the first day after the operation.