血栓弹力图预测下肢骨折围手术期深静脉血栓的应用研究  

Application of Thromboelastography for the Prediction of Deep Vein Thrombosis in the Perioperative Period of Lower Limb Fracture

作　　者：齐喆[1] 刘凤华[1] 谭淑云[1] 袁景芳[1] 张世谦[1] 于洪敏[1] QI Zhe;LIU Feng-hua;TAN Shu-yun;YUAN Jing-fang;ZHANG Shi-qian;YU Hong-min(Department of Blood transfusion branch,The first affiliated hospital of Harbin medical university,Harbin,Heilongjiang,150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院输血科

出　　处：《现代生物医学进展》2019年第11期2148-2150,2183,共4页Progress in Modern Biomedicine

基　　金：黑龙江省卫生厅科研基金项目(2012-553)

摘　　要：目的:探讨血栓弹力图(TEG)预测下肢骨折围手术期深静脉血栓的临床价值。方法:选择在我院进行体检的健康志愿献血者作为对照组(Ⅰ),同时选择82例在我院进行骨科手术的下肢骨折患者作为实验组(Ⅱ)。分别在骨折后第2天、手术当天、术后第3天、术后第7天和术后第10天进行血栓弹力图检测,比较实验组(Ⅱ)与对照组(Ⅰ)TEG各参数差异,并对所有数据进行相关性分析。结果:实验组(Ⅱ)82例研究对象中有63例(76.83%)于术后一周内出现高凝状态。与对照组(Ⅰ)比较,实验组(Ⅱ)骨折第2天、手术当天、术后第3天、术后第7天和术后第10天R、K缩短,Angle角、MA、CI值均延长。与手术当日比较,实验组(Ⅱ)术后第3天、术后第7天R和K明显缩短,Angle角、MA、CI值均明显延长(P<0.05),与术后第3天、术后第7天比较,术后第10天R、K延长,Angle角、MA、CI值有缩短趋势。结论:血栓弹力图能及时准确监测下肢骨折患者凝血状态变化情况,及时预测下肢深静脉血栓(LDVT)发生风险,为抗凝药物的合理使用提供参考依据。Objective: To explore the clinical value of thromboelastogram(TEG) in predicting deep venous thrombosis during perioperative period of lower limb fracture. Methods: Healthy voluntary blood donors who underwent physical examination in our hospital were selected as the control group(Ⅰ), and 82 cases of orthopaedic surgery patients with fracture of lower limb in our hospital during the same period were selcted as the experimental group(Ⅱ). THE thrombelastography was performed on the second day after fracture, the day of surgery, the third day after surgery, the seventh day after surgery and the tenth day after surgery, respectively. Comparing the experimental group(Ⅱ) and control group(Ⅰ) TEG each parameter difference, and to all the data correlation analysis. Results: In 82 cases of the experimental group(Ⅱ), 63 cases(76.83%) showed hypercoagulability within one week after surgery. Compared with the control group(Ⅰ), the R, K of experimental group(Ⅱ) were shortened, the Angle, MA, CI value were extended in 2 days, on the day of surgery,at 3, 7 and 10 days postoperation, Compared with those on the day of surgery, the R and K of experimental group(Ⅱ) at 3 and 7 days after surgery were significantly shortened, the Angle, MA, CI values were significantly extended(P<0.05);Compared with those on the 3 rdand7 thday after surgery, the R, K extended, the Angle, MA, CI value showed a shortening trend. Conclusion: Thrombelastography can timely and accurately monitor the changes of coagulation state of patients with lower limb fracture, timely predict the risk of lower deep venous thrombosis(LDVT), and provide references for the rational use of anticoagulant drugs.

关 键 词：血栓弹力图 深静脉血栓 骨折 

分 类 号：R683[医药卫生—骨科学]