术前血常规及凝血指标对甲状腺术后出血的应用价值  

Application Value of Preoperative Blood Routine and Coagulation Indexes in Postoperative Hemorrhage of Thyroid Gland

作　　者：谭军强 吴中强 李国劲 TAN Jun-qiang;WU Zhong-qiang;LI Guo-jin(Department of Thyroid surgery,The People’s Hospital of Gaozhou,Gaozhou,525200,China)

机构地区：[1]广东省高州巿人民医院甲状腺外科,高州525200

出　　处：《血栓与止血学》2021年第1期12-13,16,共3页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的探讨术前血常规及凝血指标对甲状腺术后出血的预测价值。方法以200例接受甲状腺手术治疗的患者为对象,根据患者术后出血与否将患者分为出血组(n=17)和未出血组(n=183)。检测患者凝血指标并分析其余甲状腺术后出血的关系。结果出血组凝血酶原时间(PT)、D二聚体(D-D)水平高于未出血组,血小板计数(PLT)、纤维蛋白原(Fbg)水平低于未出血组(P<0.05);两组活化部分凝血酶原时间(a PTT)、凝血酶时间(TT)水平比较无差异(P>0.05)。PT预测甲状腺术后出血的AUC、敏感度、特异性分别为0.861(95%CI:0.805~0.905)、83.33%、99.45%。PLT测甲状腺术后出血的AUC、敏感度、特异性分别为0.838(95%CI:0.779~0.886)、77.78%、83.06%;Fbg测甲状腺术后出血的AUC、敏感度、特异性分别为0.829(95%CI:0.770~0.879)、83.33%、81.42%;D-D测甲状腺术后出血的AUC、敏感度、特异性分别为0.805(95%CI:0.743~0.857)、77.78%、78.69%。结论甲状腺术后出血与PT、PLT、Fbg、D-D等存在联系,检测上述指标有助于术后出血的诊断。Objective To explore the predictive value of preoperative blood routine and coagulation indexes for bleeding after thyroid surgery.Methods A total of 200 patients who underwent thyroid surgery were taken as the object.The patients were divided into bleeding group(n=17)and non-bleeding group(n=183)according to whether the patients had bleeding or not.Detect the patient’s coagulation index and analyze the relationship of other bleeding after thyroidectomy.Results The levels of prothrombin time(PT)and D-dimer(D-D)in the bleeding group were higher than those in the non-bleeding group,and the platelet count(PLT)and fibrinogen(Fbg)levels were lower than those in the non-bleeding group(P<0.05);There was no difference in the levels of activated partial prothrombin time(aPTT)and thrombin time(TT)between the two groups(P>0.05).The AUC,sensitivity and specificity of PT predicting postoperative thyroid bleeding were 0.861(95%CI:0.805~0.905),83.33%,and 99.45%,respectively.The AUC,sensitivity,and specificity of PLT measurement of postoperative thyroid bleeding were 0.838(95%CI:0.779~0.886),77.78%,and 83.06%,respectively;the AUC,sensitivity,and specificity of Fbg measurement of postoperative thyroid bleeding were 0.829,respectively(95%CI:0.770~0.879),83.33%,81.42%;the AUC,sensitivity,and specificity of postoperative thyroid bleeding measured by D-D were 0.805(95%CI:0.743~0.857),77.78%,78.69%,respectively.Conclusion Postoperative bleeding after thyroid is associated with PT,PLT,Fbg,D-D,etc.The detection of the above indicators is helpful for the diagnosis of postoperative bleeding.

关 键 词：血常规 凝血指标 甲状腺术后出血 

分 类 号：R653[医药卫生—外科学]