Author/Editor     Krivec, Štefka
Title     Ugotavljanje motenj hemostaze z metodo trombelastometrije
Translated title     Detection of haemostatic disorders through ThrombElastoMetry method
Type     članek
Source     In: Zbornik predavanj XLV. podiplomskega tečaja kirurgije za zdravnike, 20. in 21. november 2015 Ljubljana : Slovensko zdravniško društvo
Publication year     2015
Volume     str. 48-58
Language     slv
Abstract     Trombelastometrija (TEM), uporabljena na aparatu Rotem, je funkcijska metoda, ki temelji na principu elastometričnih meritev povečevanja viskoznosti polne krvi ob dodatku aktivatorja koagulacije. Z njo hitro in zanesljivo ugotavljamo dinamiko nastajanja krvnega strdka v citratni polni krvi. Testi, ki jih izvajamo na aparatu Rotem, so: Extem, Intem, Fibtem, Aptem in Heptem. Klinično pomembni parametri, s katerimi ocenjujemo procese v posameznem testu, so: CT (Clotting time), CFT (Clot formation time), MCF (Maximum clot firmness) in ML (Maximum lysis). Vsak od parametrov meri določeno fazo v procesu hemostaze. Spremljamo jih na grafičnem prikazu, ki se na računalniškem ekranu izrisuje v realnem času. Izvajalec testov (v laboratoriju ali ob pacientu) mora za doseganje kakovostnih rezultatov poskrbeti za celovit sistem zagotavljanja kakovosti s sledljivo dokumentacijo. TEM ima, tako kot druge metode, omejitve, ki jih je treba upoštevati pri tolmačenju rezultatov. S pravilno interpretacijo rezultatov dobimo hiter vpogled, v katerem delu hemostaze je nastala motnja. Meritev z metodo TEM je najbolj koristna v primeru akutnih krvavitev, predvsem v perioperativnem obdobju. S hitro diferencialno diagnostiko zdravnik lažje in bolj usmerjeno terapevtsko ukrepa pri odpravi nastale motnje ter tako ne sproža nepotrebnih stroškov in tudi pacient je v manjši meri podvržen potencialno škodljivim snovem.Thrombelastometry (TEM) performed with the Rotem Instrument is an established viscoelastic method for rapid and reliable detection of blood cloth formation dynamics in a sample of cytrated whole blood. Tests performed on the Rotem instrument are the following: Extem, Intem, Fibtem, Aptem and Heptem. Clinically important measurement parameters in each individual test are CT (Clotting time), CFT (Clot formaton time), MFC ( Maximum clot firmness) and ML (Maximum lysis). Each of paramaters measures a particular stage in the process of haemostasis. They are monitored on a graph that is plotted in real time. Quality assurance with traceable documentation is important requirement in laboratory and point of care (POC) testing. Like any other haemostasis evaluating method, TEM have limitations which need to be considered when interpreting the results. The correct interpretation of the results gives a quick view of the stage of haemostasis in which the disorder appeared. TEM is the most useful method in the case of acute bleedings, especially in the perioperative period. A rapid differential diagnosis permits the physician to take therapeutic measures in an easier and more targeted way to eliminate the disorder without triggering unnecessary costs, and it also prevents the patient's exposure to potentially harmful substances.
Descriptors     Hemostasis
Thrombelastography
Hemostaza
Trombelastografija
Pathology
Patologija