庞景灼,巫国勇,叶敏,庞文广,张世超,蔡成杰Vol.41(6):-

摘要：应用血栓弹力图（TEG）检测食管癌患者围手术期各个阶段的凝血功能，了解食管癌围手术期凝血功能的变化规律。指导术后抗凝或止血治疗。选取年5月至年5月医院确诊为食管癌并行手术治疗的60例患者为手术组，另选取60例健康体检者为正常对照组，通过对正常对照组、手术组术前1d、术后第1天、术后第7天的血标本进行血栓弹力图检测，分析食管癌围手术期凝血功能的变化。手术组术前和正常对照组比较，TEG参数R、K、LY30值减小，Angle、MA、CI值增大，差异有统计学意义（P0.05）。手术组术后1天和正常对照组比较，TEG参数R、K值明显减小，Angle、MA、CI值明显增大，差异有统计学意义（P0.01），LY30值减小，差异有统计学意义（P0.05）。手术组术后1d和手术组术前1d比较，TEG参数R、K值减小，LY30、Angle、MA、CI值增大，差异无统计学意义（P0.05）。手术组术后7d和术后1d比较，TEG参数R、K值减小，MA、CI值增大，差异有统计学意义（P0.05）。食管癌患者术前、术后均表现为高凝状态。手术和麻醉并没有明显改变食管癌的凝血状态。在术后恢复过程中，血液高凝状态会更明显。

关键词：食管癌；血栓弹力图；高凝状态

Abstract:Thrombelastogram（TEG）wasusedtodetectthebloodclottingfunctionofpatientswithesophagealcancerineachstageofperioperativeperiod，soastounderstandthechangepatternofbloodclottingfunctioninpatientswithesophagealcancerduringperioperativeperiod，andtoguidethepostoperativeanticoagulationorhemostasistreatment.SixtypatientsdiagnosedwithesophagealcancerwhounderwentsurgicaltreatmentbetweenMayandMayinJiangmenCentralHospitalwereselectedastheexperimentalgroup，and60casesofhealthyphysicalexaminationwereselectedasthenormalcontrolgroup.Bycontrastingwiththenormalcontrolgroup，resultsofbloodsampletestingfortheexperimentalgroup1daybefore，1dayafteroperation，andthe7thdaypostoperativethrombosiselasticfigurewereusedtoanalyzethechangeoftheesophagealperioperativebloodcoagulationfunction.Comparedwiththecontrolgroupbeforesurgery，theTEGparametersR，KandLY30decreased，andAngle，MAandCIincreased，withstatisticallysignificantdifferences（P0.05）.Comparedwiththenormalcontrolgroupaftersurgery，theRandKvaluesofTEGparametersintheexperimentalgroupdecreasedsignificantly，whileAngle，MAandCIvaluesincreasedsignificantly，withstatisticallysignificantdifferences（P0.01），andLY30valuesdecreased，withstatisticallysignificantdifferences（P0.05）.Comparedwiththeexperimentalgroupbeforeandaftersurgery，theTEGparametersRandKdecreased，andthevaluesofLY30，Angle，MAandCIincreased，withnostatisticallysignificantdifference（P0.05）.Sevendaysaftertheoperationand1dayaftertheoperation，thevaluesofRandKofTEGdecreased，andthevaluesofMAandCIincreased，withstatisticallysignificantdifferences（P0.05）.Allpatientswithesophagealcancerpresentedhypercoagulabilitybeforeandafteroperation.Surgeryandanesthesiadidnotsignificantlychangethecoagulationstatusofesophagealcancer.Inthepostoperativerecoveryprocess，thehypercoagulablestatewillbemoreobvious.

Keywords：esophagealcancer；thrombelastogram；hypercoagulability

编辑：王清波

初审：祁方昉

复审：孙慧兰余菁

审核发布：徐杰