血栓弹力图诊断脓毒症合并弥散性血管内凝血的meta分析

来源:用户上传      作者:陈艺玲 游碧君 叶梦秋 李熠容 王金辉

　　[摘要]目的u价TEG/ROTEM对脓毒症合并弥散性血管内凝血的诊断价值。方法通过检索Cochrane Library、PubMed、Embase、Web of Science、中国生物医学文献数据库（CBM）、中国知网（CNKI）、中文科技期刊全文数据库（VIP）及万方数据库，收集从建库至2021年12月有关TEG/ROTEM监测脓毒症合并DIC患者的研究，对相关文献按标准进行筛选、质量评价及获取相关数据。采用Review Manager 5.3软件进行meta分析。结果共7篇文献纳入研究，共计1214例脓毒症患者，其中DIC组303例，non-DIC组911例。meta分析显示，DIC组与non-DIC 组在死亡率[OR=3.02，95%CI （2.12，4.30），P< 0.000 01]、R[MD=1.59，95%CI （0.79，2.39），P<0.0001]/CT[MD =10.29，95%CI （6.08，14.49），P<0.000 01]、K[MD=2.14，95%CI （1.57，2.71），P<0.000 01]/CFT[MD=52.72，95%CI（21.80，83.63），P=0.0008]和MA[MD=-17.26，95%CI（-23.74，-10.79），P<0.000 01]/MCF[MD=-9.90，95%CI（-15.51，-4.29），P=0.0005]，比较，差异有统计学意义（P<0.05）。结论TEG/ROTE能够分析脓毒症合并DIC患者的凝血状态，可能是诊断脓毒症合并DIC的有效工具，评估血栓、出血风险，并指导临床治疗。
　　[关键词]血栓弹力图;旋转血栓弹力图;弥散性血管内凝血;脓毒症;meta分析
　　[中图分类号]R459.7;R543[文献标识码]A[文章编号]2095-0616（2022）13-0052-05
　　Meta-analysis of the diagnostic valve of thromboelastography（TEG）or rotational thromboelastometry（ROTEM）for septic disseminated intravascular coagulation
　　CHEN YilingYOU BijunYE MengqiuLI YirongWANG Jinhui
　　Department of Blood Transfusion，Xiamen Children's Hospital，Fujian，Xiamen 361006，China
　　[Abstract] Objective To evaluate the diagnostic value of thromboelastography（TEG）/rotational thromboelastometry（ROTEM）in sepsis complicated with disseminated intravascular coagulation （DIC）. Methods Studies on TEG/ROTEM monitoring patients with sepsis complicated with DIC included in Cochrane Library，PubMed，Embase，Web of Science，China Biology Medicine （CBM）disc，China National Knowledge Internet （CNKI），Chinese Science and Technology Journal Full-text Database （VIP）and Wanfang database from the establishment of the databases to December 2021 were collected，and relevant literature was conducted screening，quality evaluation，and relevant data acquisition according to the criteria. Meta-analysis was performed using Review Manager5.3 software. Results 7 papers were included in the study，with a total of 1214 sepsis patients. They were divided into two groups，with 303 patients in the DIC group and the rest 911 patients in the non-DIC group. Meta-analysis showed that there were statistically significant differences between the DIC group and the non-DIC group in the mortality rate （OR=3.02，95% CI [2.12，4.30]，P<0.000 01），R（MD=1.59，95%CI [0.79，2.39]，P<0.0001）/CT（MD =10.29，95%CI [6.08，14.49]，P<0.000 01），K （MD=2.14，95%CI [1.57，2.71]，P<0.000 01）/CFT（MD=52.72，95%CI[21.80，83.63]，P=0.0008）and MA（MD=-17.26，95%CI[-23.74，-10.79]，P<0.000 01）/MCF（MD=-9.90，95%CI [-15.51，-4.29]，P = 0.0005）（P<0.05）. Conclusion TEG/ROTE can analyze the coagulation status of patients with sepsis complicated with DIC，and may serve as an effective tool in diagnosing sepsis complicated with DIC，assessing the risk of thrombosis and bleeding，and guiding clinical treatment.

nlc202208181152

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