血栓弹力图在评估子宫颈癌术后化疗患者凝血状态的应用

Theme of thromboelastography inclinical application: application of thromboelastography in evaluating coagulation status of patients with cervical cancer after postoperative chemotherapy

目的探讨子宫颈癌术后化疗患者血栓弹力图(TEG)变化情况。方法回顾性调查2018年1—4月本院妇科肿瘤病房收治子宫颈癌术后化疗患者123例,对比同期健康体检89名女性TEG检测结果,分析TEG参数差异。结果在5个主要TEG参数中,子宫颈癌术后化疗患者的Angle角(69.94±5.28°vs 68.22±4.1°,P<0.05),MA值(64.13±6.58 mm vs 62.49±4.07 mm,P<0.05),CI值(1.43±1.67 vs 0.99±1.16,P<0.05)均显著高于健康体检对照组,分层分析后发现Ⅰ—Ⅱ期患者与健康体检组无差异(P>0.05),Ⅲ—Ⅳ期患者与健康体检组相比5个主要参数均有差异(P<0.05),不同疾病分期患者的TEG参数也存在差异,Ⅰ—Ⅱ期患者TEG的R值(5.39±1.02 min vs 5.01±0.82 min,P<0.05)和K值(1.53±0.58 min vs 1.31±0.35 min,P<0.05)高于Ⅲ—Ⅳ期,Angle角(68.68±5.33°vs71.11±4.67°,P<0.05)和CI值(1.08±1.74 vs 1.73±1.44,P<0.05)低于Ⅲ—Ⅳ期。结论子宫颈癌术后患者血液状态以高凝为主要特征,为了降低术后血栓的发生率,以及提高输血治疗的合理性,建议临床对其实施TEG监测,了解患者的凝血功能。

Objective To investigate the changes of Thromboelastography(TEG)in patients with cervical cancer after postoperative chemotherapy.Methods A retrospective survey was conducted on 123 patients with cervical cancer who received postoperative chemotherapy in the gynecologic oncology ward in Shengjing Hospital of China Medical University from January to April 2018.The results of TEG test of 89 healthy women,enrolled as the healthycontrol groupin the same period,were compared,and the differences of TEG parameters were analyzed.Results Among the five main TEG parameters,the Angle angle(69.94±5.28°vs.68.22±4.1°,P<0.05),maximum amplitude(MA)value(64.13±6.58 mm vs.62.49±4.07 mm,P<0.05),and CI values(1.43±1.67 vs.0.99±1.16,P<0.05)in cervical cancer patients were significantly higher than those in the control group.No statistical difference between stage I-II patients and healthy control groupwasobserved(P>0.05),andstatistically significant differences inall five major parametersbetween stage III-IV patients and healthy control group wereobserved(P<0.05).TEG parameters were also different in patients with different disease stages.The values of R(5.39±1.02 min vs.5.01±0.82 min,P<0.05)and K(1.53±0.58 min vs.1.31±0.35 min,P<0.05)in patients with stage I-II were higher than stage III-IV,while theα-angle(68.68±5.33°vs.71.11±4.67°,P<0.05)and CI values(1.08±1.74 vs.1.73±1.44,P<0.05)were lower than stage III-IV.Conclusion High coagulation is the main characteristic in patients with cervical cancer after postoperative chemotherapy.In order to reduce the incidence of postoperativethrombosis and improve the rationality of blood transfusion treatment,it is suggested to use TEG monitoring in clinicalto understand the coagulation function of patients.