血栓弹力图参数指导Ⅱb期宫颈癌手术患者输血治疗效果及预后评估价值  

Effect of the thromboelastography parameters in guiding blood transfusion therapy of patients with surgery of the cervical cancer stageⅡb and its influence on the prognosis of the ptients

作　　者：吴立平 陈杰 曾峥 李静 全晖 程双华 WU Liping;CHEN Jie;ZENG Zheng;LI Jing;QUAN Hui;CHENG Shuanghua(The Second Affiliated Hospital of Chengdu Medical College/China National Nuclear Corporation 416 Hospital,Chengdu,Sichuan Province,610051;General Medical 363 Hospital,Chengdu,Sichuan Province)

机构地区：[1]成都医学院第二附属医院/核工业四一六医院,610051 [2]通用医疗三六三医院

出　　处：《中国计划生育学杂志》2025年第4期920-924,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨血栓弹力图(TEG)参数指导Ⅱb期宫颈癌手术患者输血治疗及评估预后价值。方法:对2021年1月-2024年1月本院收治的Ⅱb期宫颈癌手术患者70例临床资料进行回顾性分析,根据输血指导方式将行常规凝血检测指导输血的患者纳入常规组(n=21),将行TEG参数指导输血的患者纳入TEG参数组(n=49),比较两组血制品用量、输血治疗前1 d(T0)、输血治疗后3 d(T1)凝血指标;根据TEG参数组住院期间是否出现下肢深静脉血栓形成(DVT),分为血栓组(n=12)和非血栓组(n=37),绘制受试者工作特征(ROC)曲线,获取TEG参数预测Ⅱb期宫颈癌术后发生下肢DVT的曲线下面积(AUC)、敏感度、特异度、置信区间和截断值。结果:常规组和TEG参数组红细胞使用量无差异(P>0.05),新鲜冰冻血浆、血小板、冷沉淀使用量TEG参数组均低于常规组(P<0.05);T1时,两组PT、APTT均降低且TEG参数组更低,两组FIB升高且TEG参数组更高(均P<0.05);血栓组凝血反应时间(R)、凝固时间(K)值低于非血栓组,凝血最终强度(MA)、凝血综合指数(CI)值高于非血栓组(均P<0.05),两组Angel、PT、APTT、FIB比较无差异(P>0.05)。ROC曲线分析,TEG参数R、K、MA、CI值及联合预测的AUC均>0.7,其中联合预测的AUC最大(0.959)。结论:宫颈癌术后行TEG参数指导输血,可有效降低血制品用量,改善患者凝血指标,使围术期输血治疗更加科学合理。同时,TEG参数联合预测宫颈癌患者术后下肢DVT的发生有一定应用价值。Objective:To investigate the effect of thromboelastography(TEG)parameters of patients with surgery of the cervical cancer stage IIb on guiding their blood transfusion therapy,and to study the value of the TEG of the patients for evaluating their prognosis.Methods:The clinical data of 70 patients with surgery of the cervical cancer stage IIb in the hospital from January 2021 to January 2024 were analyzed retrospectively.According to the blood transfusion guidance methods,21 patients who received the routine coagulation test to guide their blood transfusion were included in the control group and 49 patients who had been carried out the TEG parameters to guide their blood transfusion were included in the observation group.The amount of blood products consumption and the coagulation indexes values at 1 day before blood transfusion therapy(T0)and at 3 days after blood transfusion therapy(T1)of the patients were compared between groups.According to whether the lower extremity deep venous thrombosis(DVT)of the patients occurred or not during hospitalization,the patients in the observation group were further divided into group A(12 patients with DVT)and group B(37 patients without DVT).Receiver operating characteristic(ROC)curve was drawn to obtain the area under the curve(AUC),the sensitivity,the specificity,the confidence interval and the cutoff value of the TEG parameters of the patients for predicting their lower extremity DVT occurrence after the surgery of cervical cancer stage IIb.Results:There was no significant difference in the amount of the red blood cells consumption of the patients between the control group and the observation group(P>0.05).The amount of the fresh frozen plasma,platelets,and cryoprecipitate used of the patients in the observation group were significantly lower than those of the patients in the control group(P<0.05).At T1,the values PT and APTT of the patients in the two groups had decreased significantly,and which of the patients in the observation group were significantly lower.The FIB valu

关 键 词：Ⅱb期宫颈癌 输血治疗 血栓弹力图参数 静脉血栓栓塞 凝血指标 预测 

分 类 号：R737.33[医药卫生—肿瘤]