Overall Evaluation Of POCT Coagulation Function

The so-called overall evaluation means that this type of equipment is different from the previous method of single detection of the number and activity of certain coagulation components, and usually records the whole process of blood from coagulation to fibrinolysis, so it provides a more comprehensive basis for all aspects of the patient's coagulation function. Information, has formed a unique POCT category. At present, there are mainly two types of POCT in China, both of which are based on the changes of viscoelasticity during blood coagulation. Thrombelastography, the so-called TEG (Thrombelastography, Haemoscope, IL, USA), generates a coagulation force curve with the increase and decrease of the clot strength during detection, which can intuitively reflect the situation of whole blood agglutination and fibrinolysis. According to the author's clinical application experience in recent years, this method is more standardized than the platelet aggregation rate, does not require cumbersome specimen processing, and has good reproducibility, and its performance evaluation has been described in another paper. Platelet function analysis has strict requirements on time. In principle, it should be completed within 2 hours after blood collection to reflect the actual level of coagulation function in the body. The results of anticoagulation of fresh blood without anticoagulation are more reliable than that of citrate anticoagulation. The overall detection time of TEG and platelet aggregation rate is roughly the same. If the detection speed is further improved, it will bring greater convenience to the clinic. The recently launched RapidTEG test has been greatly improved, and it can also provide ACT. There are differences in the results of TEG determination of arterial and venous blood, and TEG reflects stronger arterial blood agglutination, in addition to gender differences. TEG is widely used in cardiac surgery, liver transplantation, trauma, and obstetrics to detect blood coagulation and fibrinolysis, especially in predicting bleeding. Although some scholars prefer the traditional coagulation test and believe that the sensitivity and specificity are better, it cannot be denied that TEG better reflects the coagulation and fibrinolysis process than the conventional coagulation index, and is closer to the actual situation of coagulation in the body. The clinical value may be higher than that of single coagulation factor deficiency or decreased coagulation function expressed over time. 60 years of development and perfection have made the application of TEG in guiding component blood transfusion mature day by day. Unfortunately, there is no international standard or guideline related to blood transfusion, which also provides space for our research and application.