Thromboelastography in elective total hip arthroplasty  

作　　者：Patryck Lloyd-Donald Wen-Shen Lee Guo-Ming Liu Rinaldo Bellomo Larry McNicol Laurence Weinberg 

机构地区：[1]Department of Anesthesia,Austin Health,Heidelberg 3084,Victoria,Australia [2]Department of Intensive Care,Austin Hospital,Melbourne 3084,Victoria,Australia [3]Department of Surgery,The University of Melbourne,Austin Health,Melbourne 3084,Victoria,Australia

出　　处：《World Journal of Orthopedics》2021年第8期555-564,共10页世界骨科杂志（英文版）

摘　　要：BACKGROUND Hypercoagulability plays an important role in predisposing patients to venous thromboembolism(VTE)after total hip arthroplasty(THA).We used thromboelastography(TEG)to examine the coagulation status of patients undergoing THA.AIM To examine coagulation as measured by TEG in patients undergoing THA who received standard VTE chemoprophylaxis with enoxaparin.METHODS After ethical approval,we performed a retrospective analysis of data collected in patients undergoing primary elective THA.We analyzed TEG data on samples performed before skin incision,intraoperatively and for 5 d postoperatively.Conventional coagulation tests were performed preoperatively and on postoperative day 5.RESULTS Twenty patients undergoing general anesthesia and 32 patients undergoing spinal anesthesia(SA)were included.TEG demonstrated a progressively hypercoagulable state postoperatively,characterized by elevated maximum amplitude.TEG also demonstrated transient intraoperative hypercoagulability in patients receiving SA.In contrast,conventional coagulation tests were normal in all patients,pre-and postoperatively,except for an increase in plasma fibrinogen day 5 postoperatively.CONCLUSION Despite VTE prophylaxis,patients following total hip replacement remain in a hypercoagulable state as measured by both TEG and conventional tests.This group may benefit from more optimal anticoagulation and/or additional perioperative hemostatic monitoring,via TEG or otherwise.

关 键 词：Surgery ORTHOPEDIC ANESTHESIA Hip arthroplasty HYPERCOAGULABILITY THROMBELASTOGRAPHY 

分 类 号：R687.4[医药卫生—骨科学]