血栓弹力图在骨科围术期中的临床分析研究

Clinical Analysis and Study of Thromboelastography in the Perioperative Period of Orthopedics

目的:分析血栓弹力图在骨科围术期中的临床价值。方法:选择2019年3月~2019年12月在本院住院治疗的骨科围术期患者66例为观察组;同期选择来本院体检的健康成年人60例为对照组。检测对照组当天以及观察组患者手术前、术后3d、术后1周、术后2周的血栓弹力图。分析观察组血栓弹力图异常情况,对比两组研究对象的血栓弹力图各参数。结果:术后3d,观察组出现高凝状态,术后1周到达高峰,术后第2周开始回落。对照组血栓弹力图各参数均在正常范围内。和对照组相比,观察组患者术前、术后3d、术后1周及2周出现K、R值降低,MA、CI值、Angle角增加,差异具有统计学意义(P<0.05);和术前相比,术后3d、术后1周K、R值降低,MA、CI值、Angle角增加,差异具有统计学意义(P<0.05);与术后3d、术后1周相比,术后2周K、R值增加,MA、CI值、Angle角下降,差异具有统计学意义(P<0.05)。结论:血栓弹力图可动态监测骨科手术患者围术期的凝血指标,从而早期预防血栓的发展。

Objective:To analyze the clinical value of thromboelastography in the perioperative period of orthopedics.Methods:66 orthopedic perioperative patients who were hospitalized in our hospital from March 2019 to December 2019 were selected as the observation group;during the same period,60 healthy adults who came to our hospital for physical examination were selected as the control group.The thromboelastograms of the control group and patients in the study group were tested on the day before the operation,3 days after the operation,1 week after the operation,and 2 weeks after the operation.Analyze the abnormalities of the thromboelastogram of the study group,and compare the parameters of the thromboelastogram of the two groups of subjects.Results:On the 3 days after the operation,the study group developed hypercoagulable state,which reached a peak 1 week after the operation,and began to fall back on the 2nd week after the operation.The parameters of the control group’s thromboelastogram were all within the normal range.Compared with the control group,patients in the study group had lower K and R values before operation,3 days after operation,1 week and 2 weeks after operation,and increased MA,CI values,and Angle angle.The difference was statistically significant(P<0.05);Compared with before operation,K and R values decreased at 3 days after operation and 1 week after operation,and MA,CI values,and Angle angle increased,and the difference was statistically significant(P<0.05);compared with 3 days after operation and after operation Compared with 1 week,K and R values increased at 2 weeks postoperatively,and MA,CI values,and Angle angle decreased.The difference was statistically significant(P<0.05).Conclusion:Thromboelastography can dynamically monitor the perioperative coagulation indexes of orthopedic surgery patients,so as to prevent the development of thrombosis in the early stage.It is worthy of popularization and application in orthopedics.