血栓弹力图在预防肺癌患者术后深静脉血栓中的应用研究

Application of Thromboelastography in Prevention of Postoperative Deep Venous Thrombosis in Patients with Lung Cancer

目的探讨血栓弹力图(TEG)及相关检验指标在预防老年肺癌患者术后下肢深静脉血栓(DVT)形成中的应用价值。方法选取2021年6月至2022年6月手术治疗的肺癌患者150例,收集患者的一般资料,术前接受常规凝血指标检测和TEG检查。根据患者术后是否发生DVT将150例患者分为DVT组(14例)和非DVT组(136例),比较2组患者的常规凝血指标[凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、D-二聚体]及TEG指标[凝血反应时间(R值)、血凝块形成时间(K值)、凝固角(α值)、最大振幅(MA值)]。结果DVT组和非DVT组PT、APTT、TT水平差异均无统计学意义(P>0.05);DVT组TEG指标和D-二聚体水平明显高于非DVT组,组间差异有统计学意义(P<0.05)。高龄是肺癌手术患者术后发生DVT的危险因素(P<0.05)。结论与常规凝血指标相比,TEG更能准确全面地评估肺癌患者围术期的凝血状态,有助于预防肺癌患者术后DVT的发生。

Objective To investigate the value of TEG and relative test in preventing deep venous thrombosis(DVT)of lower extremity in elderly patients with lung cancer.Methods 150 cases of lung cancer were selected.We collected general data of patients,received conventional coagulation indicators test and TEG before operation,analyzed the predictive value of TEG on DVT by intravenous ultrasonography,and divided 150 patients into DVT group(14 patients)and normal group(136 patients),according to whether or not the patients had DVT after operation.Compared the 2 groups indicators of patients:prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),D-dimer,reaction time(R value),and clot formation time(K value),solidification angle(αvalue),maximum amplitude(MA value).Results There was no significant difference in the levels of PT,APTT and TT between DVT and non-DVT groups(P>0.05).The levels of TEG and D-dimer in DVT group were significantly higher than those in non-DVT group(P<0.05).Old age was a risk factor for postoperative DVT in patients with lung cancer(P<0.05).Conclusion Compared with conventional coagulation indicators,TEG can improve the accuracy of DVT screening in patients with lung cancer after operation.