目的 分析胃热壅盛证急性非静脉曲张性上消化道出血（Acute Non-variceal Upper Gastrointestinal Bleeding，ANVUGIB）患者应用生地泻心汤联合矛头蝮蛇血凝酶治疗的效果。方法 收集2022-02—2025-09我院确诊的ANVUGIB患者98例为研究对象，按照治疗方案分为研究组与对照组，其中接受矛头蝮蛇血凝酶治疗的49例患者作为对照组，接受生地泻心汤、矛头蝮蛇血凝酶联合治疗的49例作为研究组。观察两组疗效、再出血率、止血效果、中医证候积分、安全性、凝血功能指标[全血活化部分凝血活酶时间（Activated Partial Thromboplastin Time，APTT）、凝血酶原时间（Prothrombin Time，PT）、血浆D-二聚体（D-Dimer，D-D）、纤维蛋白原（Fibrinogen，FIB）水平]、全血血红蛋白（Hemoglobin，Hb）、红细胞压积（Hematocrit，HCT）、红细胞计数（Red Blood Cell Count，RBC）以及血清尿素氮（Blood Urea Nitrogen，BUN）水平。结果 研究组治疗有效率93.88%比对照组77.55%高（P＜0.05）；与对照组相比，治疗12h、24h、48h研究组有效止血率较高，出血停止时间较短（P＜0.05）；治疗1周后，研究组中医证候积分低于对照组（P＜0.05）；研究组再出血率低于对照组（P＜0.05）；治疗1周后，研究组PT、APTT短于对照组，血浆D-D、FIB水平低于对照组（P＜0.05）；治疗1周后，研究组全血RBC、Hb、HCT水平高于对照组，血清BUN水平低于对照组（P＜0.05）；两组治疗期间未发生不良反应。结论 胃热壅盛证ANVUGIB患者应用生地泻心汤联合矛头蝮蛇血凝酶治疗效果确切，可缩短出血时间，减轻临床症状，改善凝血功能与循环血容量，且未见不良反应。

目的 探讨肝硬化患者临床凝血功能检验中全自动血凝仪测定的应用及临床价值。方法 选取2018年1月—2020年1月我院收治的64例肝硬化患者(肝硬化组),并纳入同期来我院接受健康体检者64例(对照组),应用全自动血凝仪对肝硬化患者临床凝血指标检测。再将肝硬化组患者分为出血组与无出血组,比较对照组与肝硬化组、出血与无出血组、不同肝功能分级患者血小板参数与PT检测结果。结果 与对照组比较,肝硬化组PDW、PT、MPV、INR水平更高,PCT、PLT水平更低(P＜0.05);与肝硬化无出血组比较,肝硬化出血组PDW、PT、MPV、INR水平更高,PCT、PLT水平更低(P＜0.05);与Child-Pugh A级患者比较,肝硬化Child-Pugh B级与C级患者PDW、PT、MPV、INR水平更高,PCT、PLT水平更低(P＜0.05)。结论 在肝硬化患者病情评价中凝血功能检验发挥重要作用,可为患者临床治疗提供有效理论依据,诊断准确率较高,有利于临床治疗措施制定。因此,凝血功能检验应在肝硬化疾病诊断中广泛应用。

Objective To explore the application and clinical value of automatic blood coagulation apparatus in clinical coagulation function test of patients with cirrhosis. Methods A total of 64 patients with cirrhosis admitted to our hospital from January 2018 to January 2020 (cirrhosis group) were selected, and 64 healthy subjects admitted to our hospital during the same period (control group) were included. The clinical coagulation indexes of patients with cirrhosis were detected by automatic blood coagulation apparatus. Patients in cirrhosis group were divided into bleeding group and non-bleeding group; platelet parameters and PT test results were compared between control group and cirrhosis group, bleeding group and non-bleeding group, and patients with different liver function grades. Results Compared with the control group, the levels of PDW, PT, MPV and INR in cirrhosis group were higher, and the levels of PCT and PLT were lower (P＜0.05). Compared with liver cirrhosis non-bleeding group, the levels of PDW, PT, MPV and INR were higher in liver cirrhosis with bleeding group, and the levels of PCT and PLT were lower (P＜0.05). Compared with Child-Pugh A patients, the levels of PDW, PT, MPV and INR in Child-Pugh B and C patients with cirrhosis were higher, and the levels of PCT and PLT were lower (P＜0.05). Conclusion The test of coagulation function plays an important role in the evaluation of patients with cirrhosis, and can provide effective theoretical basis for the clinical treatment of patients with high diagnostic accuracy, which is conducive to the formulation of clinical treatment measures. Therefore, the test of coagulation function should be widely used in the diagnosis of cirrhosis.

凝血功能障碍是围术期临床关注的重点,评价方式较多,其中血栓弹力图(TEG)可根据凝血过程中血凝块的黏弹性变化所描绘出的图像,反映全血的凝血和纤溶能力,其结果快速准确,被广泛应用围术期凝血功能监测。

Coagulopathy is a key concern around operation period.Thromboelastography (TEG) is in the process of image based on viscoelastic changes of coagulation of blood clots depicted, to reflect the blood coagulation and fibrinolytic capacity. TEG test result is quickly and accurately, therefore it is widely used in the perioperative monitoring of blood coagulation function, blood transfusion guide, hypercoagulation monitoring, prevention of thrombosis.