| 禹 梅,李 娜,寇长元,方晓蕾,李清华,张慧君.血栓弹力图评估胃癌患者围手术期凝血状态的应用研究[J].,2017,17(14):2721-2724 |
| 血栓弹力图评估胃癌患者围手术期凝血状态的应用研究 |
| A Clinical Study on TEG for the Evaluation of Blood Coagulation State of Patients with Gastric Cancer during Perioperative Period |
| 投稿时间：2016-12-07 修订日期：2016-12-31 |
| DOI：10.13241/j.cnki.pmb.2017.14.030 |
| 中文关键词: 血栓弹力图 胃癌 凝血状态 准确率 |
| 英文关键词: Thrombelastogram Gastric cancer Coagulation Accuracy |
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| 中文摘要: |
| 摘要 目的：探讨血栓弹力图评估胃癌患者围手术期凝血状态的临床应用价值。方法：选择2013年8月至2016年8月在我院进行治疗的胃癌患者80例作为观察组，同时选择同期在我院治疗的胃部良性疾病患者80例作为对照组。采用TEG评估两组患者的凝血功能，并且与常规凝血检查比较，分析两种凝血评估方法的准确率。结果：Ⅰ期胃癌患者的TEG各指标与对照组相比差异无统计学意义(P>0.05)，Ⅱ期胃癌患者的R值、K值、MA值以及CI值与对照组比较差异显著，具有统计学意义(P<0.05)，Ⅲ和Ⅳ胃癌患者的TEG各指标与对照组相比差异显著，具有统计学意义(P<0.05)；发生淋巴结转移的胃癌患者TEG各指标与对照组相比差异显著，具有统计学意义(P<0.05)，而没有发生淋巴结转移的患者与对照组相比差异无统计学意义(P>0.05)；进展期胃癌患者的TEG各指标与对照组比较差异显著，具有统计学意义(P<0.05)，而早期胃癌的TEG各指标与对照组差异不显著(P>0.05)；观察组患者治疗后，TEG检测血液发生低凝状态的检出率77.23%，常规检出率是46.15%；54例非出血患者中，TEG检出血液非凝状态的检出率为94.44%，常规检出率为77.78%。两种检测方法的检出率比较差异具有统计学意义(P<0.05)。结论：胃癌患者的血液处于高凝状态，且高凝状态与病情发展的恶性程度呈正相关，TEG评估胃癌患者围术期的凝血状态较常规凝血检验更准确。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical value of thrombelastogram (TEG) for the evaluation of blood coagulation state of patients with gastric cancer during perioperative period. Methods: 80 gastric cancer patients were collected as study group in our hospital from January 2014 to January 2016, and 80 patients with benign gastric diseases for treatment in our hospital were enrolled as control group in the same period. The blood coagulation status of patients in two groups were evaluated with TEG, and the accuracy for assessment blood coagulation compared with the conventional blood coagulation detection. Results: No significant difference was found in the TEG parameters between Ⅰ phase gastric cancer patients and control patients(P>0.05); Significant difference of TEG parameters including R, K, MA and CI was found between Ⅱ phase gastric cancer patients and control patients (P<0.05). Significant difference of TEG parameters between Ⅲ/Ⅳ phase gastric cancer patients and control patients was found(P<0.05); Significant difference of TEG parameters between gastric cancer patients with lymph node metastasis and control patients was observed (P<0.05), but no significant difference was found between patients with no lymph node metastasis and control patients (P>0.05). Significant difference of TEG parameters between advanced gastric cancer patients and control patients was found(P<0.05), but no significant difference was found between early gastric cancer patients and control patients (P>0.05). 26 cases of hemorrhage patients in the study group, the detection of hypercoagulable with TEG was 77.23%, and the conventional detection rate was 46.15% (X2=6.571, P=0.037); 54 cases of no hemorrhagic patients in the study group, the detection of non-hypercoagulable with TEG was 94.44%, and the conventional detection rate was 77.78% (P=0.047). Conclusion: The blood state of gastric cancer patients was hypercoagulable, and the severity was positively related with the development of disease. To evaluate blood coagulation with TEG for patients with gastric cancer was more accuracy than conventional coagulation detection during perioperative period, which could effectively provide more accurate and useful data for clinical treatment, prevent the incurrence of adverse reaction induced by coagulation. |
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