论文部分内容阅读
目的:比较骨科不同疾病患者的术前血栓弹力图(TEG)各参数值,分析术前TEG与高凝状态和围手术期下肢深静脉血栓(DVT)的关系,探讨骨科疾病患者术前TEG检测的必要性。方法:选取骨科2015-09-2016-06收治患者266例,按疾病种类不同分为关节炎组60例、骨折组47例、坏死组79例和腰颈椎组80例共4组作为观察组。选取同期健康体检者100例作为对照组。记录各组术前TEG结果进行统计分析。结果:各观察组与对照组比较,术前TEG结果异常率均增高(P<0.05);观察组与对照组的术前TEG参数均值比较,关节炎组的K值降低,Angle角、MA值、G值增高(均P<0.05);骨折组和坏死组的R值和K值降低,Angle角、MA值、G值增高(均P<0.05)。关节炎组与骨折组的DVT发生率均比对照组、坏死组、腰颈椎组高(均P<0.05)。骨折组术前DVT患者比术后DVT患者的Angle角增大、MA延长、G增强(均P<0.05)。结论:创伤性骨折患者、骨性关节炎患者和缺血性骨坏死患者在术前处于高凝状态的比例较高,前两者围手术期DVT的发生率及其术前TEG结果异常率均增高;该3种骨科疾病患者的术前TEG检测非常必要。
OBJECTIVE: To compare the values of preoperative TEG in patients with different diseases of orthopedics, analyze the relationship between preoperative TEG and hypercoagulable state and perioperative deep venous thrombosis (DVT), and discuss the preoperative TEG detection in patients with orthopedic diseases Necessity. Methods: Two hundred and sixty-six patients admitted to orthopedics department from September 2015 to September 2016 were divided into arthritis group (n = 60), fracture group (n = 47), necrosis group (n = 79) and lumbar group (n = 80) Select the same period of 100 healthy physical examination as a control group. The preoperative TEG results were recorded and statistically analyzed. Results: Compared with the control group, the abnormal TEG results were higher in the observation group and the control group (P <0.05). Compared with the mean preoperative TEG parameters in the observation group and the control group, the K value in the arthritis group was decreased, and the Angle and MA values (All P <0.05). The values of R and K in the fracture group and the necrosis group were decreased, while the Angle, MA and G values were increased (all P <0.05). The incidence of DVT in arthritis group and fracture group were higher than those in control group, necrosis group and lumbar group (all P <0.05). The Angle Angle of the preoperative DVT patients in the fracture group was longer than that in the postoperative DVT patients, and the prolongation of the MA and the enhancement of G (all P <0.05). Conclusion: Patients with traumatic fracture, osteoarthritis and ischemic osteonecrosis patients had a high proportion of patients with hypercoagulable state before surgery. The incidence of perioperative DVT and the abnormal rate of preoperative TEG results Increased; the three kinds of orthopedic diseases preoperative TEG detection is very necessary.