血栓弹力图在食管癌患者围手术期检测中的意义  

Clinical Significance of the Application of Thrombelastogram in Perioperative Detection of Esophageal Cancer Patients

作　　者：庞景灼[1] 巫国勇[2] 叶敏[1] 庞文广[1] 张世超 蔡成杰[1] PANG Jing-zhuo;WU Guo-yong;YE Min;PANG Wen-guang;ZHANG Shi-chao;CAI Cheng-jie(Department of Thoracic Surgery,Central Hospital of Jiangmen,Jiangmen 529030,China;Department of Thoracic Surgery,The First Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]江门市中心医院胸外科,广东江门529030 [2]中山大学第一附属医院胸外科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2020年第6期975-980,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：江门市医疗卫生科技计划(2017A2052)。

摘　　要：【目的】应用血栓弹力图(TEG)检测食管癌患者围手术期各个阶段的凝血功能,了解食管癌围手术期凝血功能的变化规律。指导术后抗凝或止血治疗。【方法】选取2017年5月至2019年5月期间在江门市中心医院确诊为食管癌并行手术治疗的60例患者为手术组,另选取60例健康体检者为正常对照组,通过对正常对照组、手术组术前1 d、术后第1天、术后第7天的血标本进行血栓弹力图检测,分析食管癌围手术期凝血功能的变化。【结果】手术组术前和正常对照组比较,TEG参数R、K、LY30值减小,Angle、MA、CI值增大,差异有统计学意义(P<0.05)。手术组术后1天和正常对照组比较,TEG参数R、K值明显减小,Angle、MA、CI值明显增大,差异有统计学意义(P<0.01),LY30值减小,差异有统计学意义(P<0.05)。手术组术后1 d和手术组术前1 d比较,TEG参数R、K值减小,LY30、Angle、MA、CI值增大,差异无统计学意义(P>0.05)。手术组术后7 d和术后1 d比较,TEG参数R、K值减小,MA、CI值增大,差异有统计学意义(P<0.05)。【结论】食管癌患者术前、术后均表现为高凝状态。手术和麻醉并没有明显改变食管癌的凝血状态。在术后恢复过程中,血液高凝状态会更明显。【Objective】Thrombelastogram(TEG)was used to detect the blood clotting function of patients with esophageal cancer in each stage of perioperative period,so as to understand the change pattern of blood clotting function in patients with esophageal cancer during perioperative period,and to guide the postoperative anticoagulation or hemostasis treatment.【Methods】Sixty patients diagnosed with esophageal cancer who underwent surgical treatment between May 2017 and May 2019 in Jiangmen Central Hospital were selected as the experimental group,and 60 cases of healthy physical examination were selected as the normal control group.By contrasting with the normal control group,results of blood sample testing for the experimental group 1 day before,1 day after operation,and the 7th day postoperative thrombosis elastic figure were used to analyze the change of the esophageal perioperative blood coagulation function.【Results】Compared with the control group before surgery,the TEG parameters R,K and LY30 decreased,and Angle,MA and CI increased,with statistically significant differences(P<0.05).Compared with the normal control group after surgery,the R and K values of TEG parameters in the experimental group decreased significantly,while Angle,MA and CI values increased significantly,with statistically significant differences(P<0.01),and LY30 values decreased,with statistically significant differences(P < 0.05). Compared with the experimental group before and after surgery,the TEG parameters R and Kdecreased,and the values of LY30,Angle,MA and CI increased,with no statistically significant difference(P > 0.05).Seven days after the operation and 1 day after the operation,the values of R and K of TEG decreased,and the values of MAand CI increased,with statistically significant differences(P < 0.05).【Conclusion】All patients with esophageal cancerpresented hypercoagulability before and after operation.Surgery and anesthesia did not significantly change the coagulationstatus of esophageal cancer. In the postoperative rec

关 键 词：食管癌 血栓弹力图 高凝状态 

分 类 号：R655[医药卫生—外科学]