Application of thromboelastography and coagulation index in the treatment of calf muscular venous thrombosis with low molecular weight heparin
Objective:To investigate the clinical guiding value of Thromboelastography(TEG)and convention-al coagulation tests(CCT)in the treatment of calf muscular venous thrombosis(CMVT)with low molecular weight heparin(LMWH).Methods:Forty-two patients undergoing major orthopedic surgery and preoperative CMVT were randomly divided into experimental group(21 cases)and control group(21 cases).All patients were treated with prophylactic dose of enoxaparin sodium for anticoagulation after operation.Blood samples were col-lected on the 1st,3rd and 7th day after operation.The experimental group dynamically adjusted the anticoagula-tion scheme according to the test results on the 3rd day after operation,and reviewed the color Doppler ultrasound on the 7th day.The thrombolysis rate,proximal progression of thrombus,mortality,bleeding complications,and changes in TEG and CCT indexes were compared between the two groups.Results:In terms of thrombus dissolu-tion rate,the experimental group was significantly better than the control group,the difference was statistically significant(P＜0.05).There were significant differences in R,MA and CI values between the two groups at 7 days after operation(P＜0.05).In terms of the proximal progression of thrombosis,the number of cases in the experimental group was lower than that in the control group,but there was no significant difference between the two groups(P＞0.05).There was no significant difference in CCT,pulmonary embolism,mortality and bleeding rate between the two groups(P＞0.05).Conclusion:TEG and CCT have a good guiding anticoagulant effect on patients undergoing major orthopedic surgery with CMVT.
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