Objective To investigate the parameters and graph of thromboelastography (TEG) in DIC patients following brain injury. Methods TEG parameters were examined in 45 patients after traumatic brain injury. Results Among the four parameters, the R time had the highest sensitivity with lowest misdiagnosis rate whereas K time and angle a. had highest specificity with lowest wrong diagnosis rate. The changes in these parameters could indicate coagulation status following administration of low molecular weight heparin. Conclusions TEG is able to quickly and accurately diagnose DIC after traumatic brain injury. The graph and parameters of TEG can be used to monitor blood transfusion and to assess the amount and effect of heparin.%目的 观察颅脑损伤后弥散性血管内凝血(disseminated intravascular coagulation,DIC)患者的血栓弹力图(thrombelastography,TEG)参数及图形变化,探讨其意义.方法 选择颅脑损伤后DIC患者45例,行TEG检测.结果 诊断DIC敏感度最高的是R时间(灵敏度93.69％),利用R时间该参数诊断DIC漏诊率最少；特异度最高的是K时间(特异度96.96％)和α角(特异度96.96％),使用K时间和a角此两参数诊断DIC的误诊率最少.应用低分子肝素后,参数明显改变,提示凝血状态具有明确改变.结论 TEG可快捷准确的诊断颅脑损伤后DIC,在治疗上以明显直观的图形变化和参数改变指导血液制品输注,并检测、判断肝素的用量和效果.
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