| Objective: To explore the clinical significance and value of the thromboelastography(TEG)in the assessment of the blood coagulation status and the prevention of thrombosis in patients with gynecological malignant tumor.Methods:From October 2017 to December 2018,67 patients with gynecological malignant tumor were selected as observation group.Routine coagulation imaging(Conventional coagulation tests,CCTs),TEG,)was performed 1 day before operation in Zhongshan Hospital of Dalian University.Blood routine examination and double lower limb vein ultrasound examination.Sixty-seven healthy subjects were selected as the control group.Routine blood coagulation imaging(CCTs),TEG,)blood routine examination and lower limb vein ultrasound examination were performed.Observation indicators: 1.Routine CCTs Assay: plasma Thrombin Prothrombin time(PT),activated partial thrombin time(APTT),fibrinogen(FIB),thrombin time(TT),D-dimer(D D);2.TEG parameters: coagulation factor acting time(R),clot formation initial time(K),coagulation rate(Angle),platelet function parameter(MA),coagulation index(CI);3.Platelet count(PLT);4.Ultrasound results of lower extremities vein in two groups.To compare the blood indexes of two groups of patients and the ultrasonic results of lower limbs vein,and analyze the value of TEG in evaluating the circumference of gynecological malignant tumor patients.Clinical significance and value of coagulation state during operation and prevention of thrombosis.Results: 1.Comparison of TEG,CCTs and PLT counts between the observation group and the control group: the R value and K value in the observation group were significantly lower than those in the control group,and the difference was statistically significant(P < 0.05),Angel angle).The MA and CI values were significantly higher than those of the control group(P < 0.05).CCTs only showed that the FIB in the observation group was significantly higher than that in the control group(P < 0 05),andthe other indexes PT,APTT,TT,D-D had no statistical difference(P > 0 05),and there was no significant difference in the PLT count between the two groups(P > 0 05).CCTs and TEG were used to detect the coagulation function in patients with gynecological malignant tumor.The detection rate of TEG hypercoagulable state was significantly higher than that of routine CCTs and the difference was statistically significant(P < 0 05).3.Comparison of TEG indexes in patients with gynecological malignant tumors of different ages: there was no significant difference in the detection indexes of TEG in patients with gynecological malignant tumors of different ages(P > 0.05).4.Comparison of TEG detection indexes in patients with gynecological malignant tumor in different stages of observation group:(1)compared with stage ?,the R value and K value of stage ? and ? were significantly lower than those of stage ?(P < 0.05),Angel),and the values of ma and CI were significantly higher than those of stage?(P < 0.05),and there was significant difference between them(P < 0.05).(2)compared with stage ?,the value of R and K in stage ? and ? were significantly lower than those in stage ?(P < 0.05),Angel),and the value of ma and CI were significantly higher than those in stage ?(P < 0.05),and there was significant difference in R value and K value(P < 0.05).(3)compared with stage ?,the value of R and K in stage ? was significantly lower than that in stage ?(P < 0 05),Angel angle,M = 0 05,P < 0 05,P < 0 05).The values of A and CI were significantly increased and the difference was significant(P <0.05).(4)There was no statistical difference between the first and the second TEGs(P> 0.05).5.Comparison of TEG in the observation group with or without lymph node metastasis: K value in the group with lymph node metastasis was significantly lower than that in the group without lymph node metastasis(P < 0 05),Angel angle,P < 0 05,P < 0 05).There was no significant difference in R value and CI value between the two groups(P > 0 05).The MA value was significantly increased and the difference was statistically significant between the two groups(P < 0 05).Conclusion: 1.The patients with gynecological malignant tumor showedhypercoagulable state,and the hypercoagulable state was more obvious in patients with late staging and lymph node metastasis.2.Compared with routine blood coagulation and routine blood test,the TEG can more fully reflect the blood coagulation status of patients with gynecological malignant tumor,can evaluate the risk of thrombus more objectively and guide the clinical intervention,so as to improve the prognosis of patients. |
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