血栓弹力图对乳腺癌术后静脉血栓栓塞症的预测价值

Predictive value of thromboelastogram for postoperative venous thromboembolism in breast cancer patients

目的:探讨血栓弹力图(TEG)各参数对乳腺癌患者术后静脉血栓栓塞症的预测价值。方法:纳入2016年1月—2019年1月行手术治疗的乳腺癌患者75例,根据术后发生静脉血栓栓塞症与否分为病例组(35例)和对照组(40例),对比两组血栓弹力图参数。结果:术后第1天两组凝血反应时间(R值)、血凝块形成所需时间(K值)、最大振幅(MA值)差异无统计学意义(P>0.05);术后第7、14天,两组患者R值、K值、MA值差异有统计学意义(P<0.05);术后第1、14天,两组TEG两条曲线最大曲线弧度切线形成的角度(Angle值)、凝血指数(CI值)差异无统计学意义(P>0.05);术后第7天,两组患者Angle值、CI值差异有统计学意义(P<0.05);经重复测量方差分析,上述指标随着术后时间的变化而显著改变,时间与组别存在显著交互作用,表明随着时间变化,两组上述指标差异有统计学意义(P<0.05)。术后两组纤溶指数(LY30)、预测纤溶指数(EPL)差异无统计学意义(P>0.05);经重复测量方差分析,上述指标随着术后时间的变化未出现显著改变,时间与组别不存在显著交互作用,表明随着时间变化,两组LY30和EPL值水平差异无统计学意义(P>0.05)。结论:血栓弹力图中R值、K值、Angle值、MA值、CI值对乳腺癌患者术后静脉血栓栓塞症有一定的预测价值。

Objective: To investigate the predictive value of each parameter of thromboelastogram on the postoperative venous thromboembolism in breast cancer patients. Methods: Seventy-five breast cancer patients who were hospitalized for surgery during January 2016 to January2019 were divided into case group(35 cases) and control group(40 cases) according to whether venous thromboembolism occurred after surgery or not. The thromboelastogram parameters of the two groups were compared.%Results: The differences in R, K and MA values between the two groups on postoperative day 1 were not statistically significant(P>0.05). On postoperative day 7 and 14, the differences in R, K and MA values between the two groups were statistically significant(P<0.05). On postoperative days 1 and 14, the differences in Angle and CI values between the two groups were not statistically significant(P>0.05). On postoperative day 7, the differences in Angle and CI values between the two groups There was a statistically significant difference(P<0.05). The above indexes changed significantly with the change of postoperative time measured by repeated measurement ANOVA, there was a significant interaction between time and group, indicating that with the change of time, there was a statistically significant difference between the above indexes in the two groups(P<0.05). The differences in LY30 and EPL values between the two groups after surgery were not statistically significant(P>0.05). The above indexes did not change significantly with the change of postoperative time measured by repeated-measures ANOVA, and there was no significant interaction between time and group, indicating that the differences in the levels of LY30 and EPL values between the two groups were not statistically significant with the change of time(P>0.05). Conclusion: The R, K, Angle, MA, and CI values of thromboelastogram have some predictive value for the postoperative venous thromboembolism in breast cancer patients.