Contemporary Nursing

Objective To investigate the predictive effect of preoperative coagulation test and TEG on intraoperative nursing in patients with aortic dissection at different time of operation. Methods The clinical data of 87 patients with aortic dissection aneurysm who underwent surgery in our hospital from February 2023 to June 2023 were retrospectively analyzed. The results of preoperative routine coagulation and routine blood test, as well as central venous blood TEG test data within 5 minutes before and after heparinization were collected. According to the operation time, the patients were divided into emergency operation group (observation group) and elective operation group (control group). The basic clinical data (gender, age, weight), routine test results (ejection fraction, HB, HCT, PT, APTT, PLT), cardiopulmonary bypass time, TEG value before and after heparinization, operation duration, hospitalization days, blood loss, urine volume, intraoperative gauze usage, and postoperative drainage volume were compared and analyzed in the two groups. By analyzing the correlation between TEG parameters (R value, K value, α Angle, MA) and routine coagulation test (PT, APTT) and blood routine (HB, PLT), factors related to intraoperative nursing and postoperative abnormal bleeding were screened out. Results 1. There were significant differences in the timing of surgery (emergency, elective) and gender. The male patients in the observation group (emergency) were significantly more than those in the control group (elective) (P=0.025). 2. Compared with the control group, the hemoglobin volume (HCT) of the observation group was decreased by 1.26% (P<0.05), hemoglobin (HB) was not significantly different, prothrombin time (PT) was increased by 20.63%, activated partial thromboplastin time (APTT) was decreased by 8.07%, and platelet (PLT) was decreased by 19.67%. Blood loss increased by 21.8%, cardiopulmonary bypass time increased by 15.09%, and plasma infusion increased by 1.63%. Conclusion There is a significant correlation between the TEG value of patients with aortic dissection aneurysm and the number of platelets detected by conventional coagulation test. TEG plays an important role in the monitoring of coagulation function in patients undergoing dissection aneurysm surgery, which can quickly and accurately evaluate the status of coagulation function in perioperative patients, and guide clinical rational, effective and safe blood transfusion. Clear detection value of patients can improve the quality of clinical nursing.

Aortic dissection; Thromboelastogram; Intraoperative nursing