血栓弹力图预测骨折围手术期静脉血栓栓塞症的应用分析  

Analysis of the Application of TEG in Predicting VTE Perioperatively in Fracture Surgery

作　　者：罗轶 陈四梅 LUO Yi;CHEN Si-mei(The Second Affiliated Hospital of Jiangxi University of Chinese Medicine,Jiangxi Nanchang 330012;The Second Affiliated Hospital of Nanchang University,Jiangxi Nanchang 330006)

机构地区：[1]江西中医药大学第二附属医院,江西南昌330012 [2]南昌大学第二附属医院,江西南昌330006

出　　处：《中国医疗器械信息》2025年第5期107-110,共4页China Medical Device Information

基　　金：江西省卫生健康委科技计划(课题名称:血栓弹力图预测骨折围手术期静脉血栓栓塞症的实验研究,课题编号:202210812)。

摘　　要：目的:探讨血栓弹力图(TEG)在骨折围手术期静脉血栓栓塞(VTE)的应用价值。方法:纳入2023年1月~2023年12月本院骨科收治的413位骨折患者作为研究对象,将其中26位骨折围手术期发生VTE的患者作为VTE组,将387位未发生VTE骨折围手术期患者作为非VTE组,另选同期医院骨科前来体检结果无任何异常的387位健康体检者作为对照组。对比三组研究对象TEG、常规凝血指标、PLT,开展TEG与常规凝血指标、PLT相关分析。结果:对照组TEG-R、TEG-α、凝血酶原时间(PT)、纤维蛋白原(FIB)、D-二聚体(DD)及血小板(PLT)>非VTE组>VTE组,VTE组的TEG-α与非VTE组、对照组有差异(P<0.05),VTE组PT、FIB、DD、PLT>非VTE组>对照组;TEG-R与活化部分凝血活酶时间(APTT)(r=0.418,P<0.05),TEG-MA与FIB(r=0.480,P<0.05)、PLT(r=0.346,P<0.05)均呈正相关,与DD(r=-0.427,P<0.05)呈负相关。预测VTE发生的受试者操作特征曲线面积,TEG-R(AUC=0.782,P<0.05)、TEG-K(AUC=0.750,P<0.05)、TEG-α(AUC=0.747,P<0.05)、FIB(AUC=0.640,P<0.05)及DD(AUC=0.843,P<0.05),且TEG预测脉血栓栓塞症特异度高于常规凝血指标。结论:TEG检测对于骨折围手术期患者提示VTE的特异性优于常规凝血指标,对于预防血栓形成具有重要意义。Objective:Discussion on the significance of TEG in predicting VTE during the perioperative period of fractures.Methods:A total of 413 fracture patients admitted to the orthopedic department of our hospital from January 2023 to December 2023 were included as the study subjects.Among them,26 patients who experienced VTE during the perioperative period were selected as the VTE group,387 patients who did not experience VTE during the perioperative period were selected as the non VTE group,and 387 healthy individuals who had no abnormal physical examination results in the orthopedic department of the same hospital were selected as the control group.Compare three groups of research subjects:TEG,routine coagulation indicators PLT,conduct correlation analysis between TEG,routine coagulation indicators,and PLT.Results:The control group TEG-R TEG-α,prothrombin time(PT),fibrinogen(FIB),D-dimer(DD),and platelet count(PLT)>non VTE group>VTE group.There were significant differences in TEG-αlevels between the VTE group and the non VTE group,as well as the control group(P<0.05).The PT,FIB,DD,and PLT levels in the VTE group were higher than those in the non VTE group and the control group;TEG-R was positively correlated with activated partial thromboplastin time(APTT)(r=0.418,P<0.05),TEG-MA was positively correlated with FIB(r=0.480,P<0.05)and PLT(r=0.346,P<0.05),and negatively correlated with DD(r=-0.427,P<0.05).Predicting the area of the subject's operating characteristic curve for VTE occurrence,TEG-R(AUC=0.782,P<0.05),TEG-K(AUC=0.750,P<0.05),TEG-α(AUC=0.747,P<0.05),FIB(AUC=0.640,P<0.05)and DD(AUC=0.843,P<0.05),and TEG predicted venous thromboembolism with higher specificity than conventional coagulation indicators.Conclusion:TEG has a higher specificity for suggesting VTE in patients undergoing surgery for fractures than routine coagulation indicators,and it is of great significance for preventing thrombosis.

关 键 词：血栓弹力图 静脉血栓栓塞 预测价值 

分 类 号：TH776[机械工程—仪器科学与技术]