| BackgroundWith the improvement of national living standards,the incidence of digestive tract malignant tumors is increasing year by year,in which the incidence of colorectal cancer(colorectal cancer)is the second highest in digestive tract malignant tumors,second only to gastric cancer.Among the patients who receive surgical treatment of malignant tumors,venous thrombosis of lower extremities,namely venous thromboembolism((VTE Venous Thromboembolism)),is one of the more common complications.Thromboelastography((TEG Thromboelastography))is a new method to detect the whole body hemagglutination state in recent years,which can comprehensively and systematically evaluate the process of blood coagulation and fibrinolysis in blood vessels.More and more experts and scholars believe that it has a good application prospect in predicting the occurrence of venous thrombosis.The purpose of this study is to explore whether the parameters such as thromboelastogram,traditional hemagglutination routine and thrombus markers have good credibility in the process of monitoring perioperative venous thrombosis in patients with colorectal cancer.Epidemiological investigation and evidence-based medicine evidence show that the incidence of colorectal cancer is related to a variety of physical and chemical factors.Surgeons have reached a more consistent concept of total mesorectal resection in the exploration of radical treatment for patients with colorectal cancer.With the unification of the standard of operation and the continuous application of minimally invasive technology,the related perioperative complications show a more complex state.Among them,the serious consequences caused by venous thrombosis and shedding of lower extremities are often the most intractable.Th erefore,in view of how to effectively detect the blood hypercoagulable state and the risk of thrombosis in perioperative patients with colorectal cancer,the appearance of thromboelastography and its successful application in other interdisciplinary clinical departments,it makes it possible to accurately monitor blood coagulation and prevent venous thrombosis of lower extremities as soon as possible.ObjectiveWe aimed to examine the value of electroencephalography(TEG)in predict the lower extremity venous thrombosis in the patients with colorectal cancer.MethodsFrom September 2019 to December 2020,102 patients who met the admission and exclusion criteria in the Department of General surgery of Puyang Oil Field General Hospital of Henan Province were selected for laparoscopic radical resection of colorectal cancer.The age,preoperative stage,pathological stage,complication of chronic diseases(type 2 diabetes,hypertension,coronary atherosclerotic heart disease)of all patients with colorectal cancer were collected 24 hours before operation,24 hours after operation.the results of routine blood coagulation routine examination and Ultrasounds examination were collected.SPSS 21.0 software was used to analyze the data,and t-test and chi-square test were used to compare the differences of the experimental data between the venous thrombosis group and the non-thrombosis group.Binary logistic regression was used to analyze the independent risk factors of venous thromboembolism.The detection results of all patients were counted to further clarify the predictive and diagnostic value of thromboelastogram,routine coagulation examination and thrombus markers in the perioperative period of lower extremity venous thrombosis in colorectal cancer.Whether the positive detection rate of hypercoagulable state and thrombosis has statistical advantage compared with the traditional test.Results1.Among the 102 patients undergoing colorectal tumor surgery,there were 10 cases of perioperative venous thrombosis,and the incidence of lower limb venous thrombosis was9.8%.Among them,2 cases occurred on the first day after operation,3 cases on the 3rd day,3 cases on the 5th day after operation,29 cases increased MA value of thromboelastogram,and 18 cases shortened APTT/PT time of routine hemagglutination monitoring.The detection rate of hypercoagulable state by the two methods was 82.6%and 56.2% respectively,and the difference was statistically significant(P<0.016).The incidence of postoperative active bleeding and hypocoagulable state was 11.7%(12amp102).The TEG results showed that the R value was shortened in 7 cases,prolonged in 3cases and normal in 1 case.In the routine coagulation test,there were 9 cases of hypocoagulable state,5 cases of hypercoagulable state and 6 cases of normal coagulation.The detection rates of hypocoagulable state detected by the two methods were 80.0% and45.0% respectively,and the difference was statistically significant(P<0.05).024).2.In the coagulation test of 94 patients in the non-thrombus group,TEG found 61 cases of hypercoagulable state,21 cases of hypocoagulable state,12 cases of normal clotting state,and the detection rate of hypercoagulable state was 64.8%.Routine blood coagulation examination showed that 42 cases were in hypercoagulable state,27 cases were in hypocoagulable state,25 cases were in normal clotting state,and the detection rate of hypercoagulable state was 44.6%.There was significant difference between the two methods(P<0.05).The R and K values of other CRC patients in 8 patients with thrombosis were significantly shorter than those in non-thrombotic patients.The values of α angle,MA and CI increased significantly.It is worth noting that patients with CRC had higher levels of FIB than those without thrombosis.There was no significant difference in CIs,PT-INR,APTT and FIB between the two groups(P>0.05).Conclusions1.Some parameters of TEG in patients with thrombosis after 1.CRC surgery are abnormal.Among the TEG indexes,BMI > 27.85kg/,D-dimer > 9.65mg/l,postoperative MA > 74.4mm,postoperative albumin < 36.7g / l,suggesting that it has a certain predictive value for thrombosis.2.Using TEG to evaluate hypercoagulability(including VTE)and to detect the risk of bleeding in patients with CRC may have an advantage over routine hemagglutination. |
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