血栓弹力图参数在结肠癌术后并发高危静脉血栓栓塞症的预测价值

Predictive value of thromboelastography parameters in high-risk venous thromboembolism after colon cancer surgery

[目的]探讨血栓弹力图(TEG)参数在结肠癌术后并发高危静脉血栓栓塞症(VTE)的预测价值。[方法]回顾性分析180例结肠癌术后患者的临床资料,出院后随访3个月,根据是否发生VTE,分为VTE组和无VTE组,比较2组TEG相关指标,分析TEG参数对预测高危VTE结肠癌术后患者并发VTE的临床价值。[结果]与无VTE组比较,VTE组凝血形成时间(K)、凝血反应时间(R)值较低,而血栓最大振幅(MA)值、凝血综合指数(CI)值、凝固角(ɑ-Angle)值较高(P<0.05);Logistic回归分析结果提示,低K值、低R值、高CI值是影响高危VTE结肠癌患者术后并发VTE的独立危险因素(P<0.05);K值、R值、CI值及三者联合诊断结肠癌术后并发高危VTE的曲线下面积(AUC)分别为0.741、0.799、0.739和0.917。[结论] TEG可用于指导结肠癌术后高危VTE患者的预防性治疗,利于降低患者术后并发VTE的风险,K值、R值及CI值对预测患者术后并发VTE价值可,三者联合预测价值更高。

[Objective]To investigate the predictive value of thromboelastography(TEG)parameters in patients with high-risk venous thromboembolism after colon cancer surgery.[Methods]The clinical data of 180 patients with colon cancer after operation were analyzed retrospectively,followed up for 3 months after discharge,and divided into VTE group and non-VTE group according to the occurrence of VTE.In the VTE group,TEG-related indexes were compared between the two groups,and the clinical value of TEG parameters in predicting the postoperative complications of high-risk VTE gastrointestinal tumors was analyzed.[Results]Compared with the non-VTE group,the coagulation formation time(K)and coagulation reaction time(R)values of the VTE group were lower,while the thrombus maximum amplitude(MA)value,coagulation comprehensive index(CI)value,and coagulation angle(ɑ-Angle)value were higher in VTE group(P<0.05).Logistic regression analysis showed that low K value,low R value,and high CI value were independent risk factors for postoperative VTE in patients with high-risk VTE malignant gastrointestinal tumors(P<0.05).The areas under the curve(AUC)for postoperative VTE complicated by high-risk VTE colon cancer surgery were 0.741,0.799,0.739,and 0.917,respectively.[Conclusion]TEG can be used to guide the preventive treatment of patients with high-risk VTE after colon cancer surgery,which is beneficial to reduce the risk of postoperative VTE.higher.