The Clinical Application Of Thrombelastography In Patiens During Perioperative Period Of Total Hip Replacement Surgery

Purpose:The purpose of this study was to disclose the change tendency of coagulation function during the perioperative period by the recruited patients and to check out whether TEG can predict the formation of postoperative deep vein thrombus.We hoped that this study provided new ideas for the diagnosis of postoperative deep vein thrombosis.Methods:This study was divided into two parts:1?From Septembre,2012 to March,2013,We recruited 14 patients with femoral head necrosisor or recent neck of femur fracture for THR,6 males and 8 females with an average age of 63.6 years.The blood samples were respectively collected in the preoperative day and 1st?4th?7th postoperative day for TEG.The data were analysed by SPSS20,Statistical analysis used two-tailed,paired t-tests.2?From March,2013 to Decmber,2013,We recruited 14 patients with diagnosis of post operation thrombus,9 males and 5 females with an average age of 67.1 years,and collected their blood sample for TEG,then another 12 patients were randomly recruited for control study,5 males and 7 females with an average age of 60.8years,the 12 patients accepted TEG test in the forth postoperative day and did both lower extremities venous ultrasonography before discharge.we draw a graph according thrombelastograph MA,then we analysed the data by SPSS20 to find out the sensitivity and specificity of TEG by the comparison between 2 groups.Results:The whole blood coagulation function enhanced after the surgery,till reached the peak in the 4th postoperative day.And in the 7th day it slightly declined,but the coagulation far from reached the Preoperative levels.The MA value had Significant correlation with the formation of postoperative thrombus.By Setting the ultrasonic as the gold standard for the diagnosis of thrombus,the sensitivity of TEG was 0.857 and specificity was 0.577.Conclusions:Thrombelastography detects the change of blood coagulation function comprehensively and accurately,In patients undergoing major orthopedic surgery we recommend the application of TEG for monitoring changes in coagulation and guide anticoagulation therapy and transfusion,due to the poor sensitivity and specificity we do not recommend its application in prediction of thrombus.