首页|胸椎结核术中输血量对术后凝血功能的影响

胸椎结核术中输血量对术后凝血功能的影响

A correlation study of the effect of intraoperative blood transfusion volume on postoperative coagulation function of thoracic spine tuberculosis

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目的 探究胸椎结核术中输血量对术后凝血功能的影响,并对相关性进行研究.方法 筛选2020年5月至2022年10月河北省胸科医院收治的胸椎结核前路手术患者51例作为研究对象进行回顾性分析 按术中输血量分为A组(A≤400 mL,19例)、B组(400 mL<B≤800 mL,23例)、C组(C>800 mL,9例),分别于术前(T0)、术后1 d(T2)、术后7 d(T3)取静脉血,检测血常规、凝血功能和血栓弹力图.对血小板(PLT)、凝血酶原时间(PT)、国际标准化比值(INR)、R值、K值、MA值、α角参数进行方差分析,并对有效参数行LSD检验,比较各组差异,研究相关性变化趋势.结果 术后3组患者R值和K值变小,α角、MA值增大,PLT数量升高,说明术后血液处于高凝状态.T1时3组患者R值、α角、MA值、PLT参数比较,差异有统计学意义(P<0.05).T2时3组MA值、PLT比较,差异有统计学意义(P<0.05).T1时3组有效参数两两比较均有统计学意义(P<0.05).T2时A组与B组MA值差异有统计学意义(P=0.047).A组与C组PLT、MA值差异有统计学意义(P<0.05).T1时输血量与PLT、R值、MA值、α角具有相关性(P<0.05).PLT、MA值、α角与输血量之间正向相关(P<0.05).R值与输血量之间呈负相关(Rs=-0.371).T2时PLT、MA值与输血量之间呈正相关(P<0.05).结论 患者术后凝血功能处于高凝状态,PLT、R值、MA值、α角与术中输血量相关,术中输血量与术后高凝状态呈正相关.即术中输血越多,患者术后发生血栓风险越高.
Objective To explore the effect of intraoperative blood transfusion volume on postoperative coagulation function of thoracic spine tuberculosis,and to identify their correlation.Methods A total of 51 patients undergoing thoracic spine tuberculosis with an anterior approach who were admitted to the First Department of Orthopedics of Hebei Chest Hospital from May 2020 to October 2022 were screened for a retrospective analysis.Patients were divided into three groups according to the amount of intraoperative blood transfusion:Group A(≤400mL,19 cases),group B(400-800mL,23 cases),and group C(>800mL,9 cases).Venous blood was collected for routine blood test,coagulation function and thrombelastogram before surgery(T0),1 day after surgery(T2),and 7 days after surgery(T3).Analysis of variance was performed on platelets(PLT),prothrombin time(PT),international normalized ratio(INR),R value,K value,MA value and α angle,followed by the least significant difference(LSD)test on valid parameters to compare the significance and correlation.Results Significantly decreased R value and K value,and increased α angle,MA value and PLT in the three groups after surgery indicated a hypercoagulable state of blood.At T1,there were significant differences in the pairwise comparisons of the R-value,α angle,MA value and PLT(P<0.05).At T2,there were significant differences in the MA value and PLT among the three groups(P<0.05).At T1,there were significant differences in the pairwise comparisons of MA and PLT(P<0.05).At T2,there was a significant difference in the MA between group A and B(P=0.047).At T2,there were significant differences in the PLT and MA between group A and C(P<0.05).At Tl,the blood transfusion volume was significantly correlated with PLT,R value,MA value and α angle(P<0.05).PLT,MA value,and α angle were positively correlated with the amount of blood transfusion,and R value was negatively correlated with the amount of blood transfusion(Rs=-0.371).At T2,PLT and MA were positively correlated with blood transfusion volume.Conclusion Postoperative coagulation function is in a hypercoagulable state in thoracic spine tuberculosis patients.PLT,R value,MA value and α angle are correlated with intraoperative blood transfusion volume.The amount of intraoperative blood transfusion is positively correlated with postoperative hypercoagulability.The more intraoperative blood transfusions,the higher the risk of postoperative thrombosis.

thoracic spine tuberculosisblood transfusion volumecoagulation functioncorrelation

刘树仁、赵桂松、姚晓伟、王连波、李卓、付琳

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050041 石家庄市,河北省胸科医院骨一科

胸椎结核 输血量 凝血功能 相关性

河北省医学科学研究课题计划

20191021

2024

河北医药
河北省医学情报研究所

河北医药

CSTPCD
影响因子:1.075
ISSN:1002-7386
年,卷(期):2024.46(15)
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