Evaluation of TEG-guided Blood Transfusion Strategy in Patients with Gastrointestinal Bleeding

Ding Mengyuan; Cheng Wenhua; Zhou Xiu

doi:10.3969/j.issn.1004-5775.2025.24.020

Abstract：Objective:To evaluate the efficacy and safety of Thromboelastography(TEG)in guiding blood use in patients with gastrointestinal bleeding.Methods:A total of 70 patients with gastrointestinal bleeding(GIB)who admitted to the Department of Gastroenterology in sample hospital from 2020 to 2022 were selected as the research subjects.The patients who underwent TEG and traditional coagulation index detection before using blood preparations were defined as the experimental group,and the patients who only detected the traditional coagulation index were defined as the control group,with 35 cases in each group.The basic data,dosage of blood preparations,changes of coagulation index,treatment methods,bleeding time and hospital stay were compared between these two groups.Results:There was no significant difference in age,gender,symptoms and coagulation indexes between the experimental group and the control group(P＞0.05).The blood loss of the experimental group was greater than that of the control group,while the Hb was lower than that of the control group,and the differences were statistically significant(P＜0.05).The usage of Fresh Frozen Plasma(FFP),Cryoprecipitate(CRYO)and blood platelet(PLT)in the experimental group was lower than that in the control group,and the differences were statistically significant(P＜0.05);there was no significant difference in the usage of red blood cells(P＞0.05)between these two groups.The reduction of PT in the experimental group was greater than that in the control group,and the differences were statistically significant(P＜0.05).There was no significant difference in the number of patients and bleeding time among patients treated with endoscopic therapy and internal medical therapy(P＞0.05),but the number of hospitalization days in the experimental group was less than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion:Among patients with GIB,TEG combined with traditional coagulation index-guided blood transfusion strategy could significantly reduce the use of FFP,CRYO and PLT,which is safer and more effective than relying on traditional coagulation index alone and reduces medical costs.