A Clinical Study Of Thrombelastogram In Perioperative Patients With Renal Cell Carcinoma To Evaluate Coagulation Status

Objective: Application of thrombelastogram(TEG)and routine coagulation tests to estimate perioperative coagulation status in patients with renal cancer and explore the clinical value of TEG.And to study the correlation of major indicators between TEG and coagulation function.Methods: A total of 142 patients who experienced renal surgery in our hospital from January 2016 to March 2018 were selected.First,patients were divided into a kidney cancer group(97 cases)and a renal benign disease group(45 cases)according to postoperative pathological results.To evaluate the difference of coagulation function in perioperative period between two groups of patients by TEG and conventional coagulation test,and to assess the clinical value of them.Second,the kidney cancer group was analyzed separately to compare the correlation between TEG and routine blood coagulation parameters in patients with renal cell carcinoma,and to find the relationship between TEG parameters of different pathological types and different pathological stages of renal cell carcinoma.Results: Compared with the benign renal disease group,R and K value of TEG in renal cell carcinoma group were obviously shorter(P <0.01),Angel,MA,and CI values were distinctly wider(P <0.01);PT and FIB values were significantly increased in routine coagulation(P <0.01);PTA values were decreased(P <0.05);INR and DD values were increased(P <0.05);The differences in APTT and TT values were not statistically significant(P > 0.05).Compared with stage I,stage II,and stage III,there was a statistically significant difference in TEG parameters in stage IV kidney cancer(P < 0.05).Compared with patients with lymph node metastasis(N0)and non-lymphatic metastasis(N1),R,K,Angel and CI value in TEG parameters were statistically significant(P<0.05).There is a correlation between certain parameters of TEG and conventional coagulation parameters in kidney cancer patients.Conclusion: Perioperative blood of patients with renal cancer tends to be in a state of high blood coagulation,and hypercoagulability is positively related to late-stage disease.TEG is more accurate in assessing the perioperative coagulation status of kidney cancer patients and complementary to routine coagulation tests.