摘要
目的分析血栓弹力图指标与经皮肾镜碎石术患者术后出血的相关性,为临床治疗及预防提供依据。方法选取90例经皮肾镜碎石术患者的临床资料进行回顾性研究,根据有无出血分为出血组(n=19)与非出血组(n=71):1)比较出血组与非出血组的临床资料,包括性别、年龄、手术时间、肾小球滤过率(GFR)、结石长度、结石宽度、结石CT值、白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(Plt)、中心粒细胞比例、凝血酶原时间(PT)、国际标准化比率(INR)、活化部分凝血活酶时间(APTT)、D2聚体、降钙素原(PCT)、白介素-6(IL-6)、以及血栓弹力图指标(R值、K值、MA值、angle角);2)分析影响经皮肾镜碎石术患者术后出血的危险因素。3)分析K值、MA值、angle角、R值,以及联合指标的ROC曲线。结果出血组与非出血组一般资料性别、年龄、手术时间、结石长度、结石宽度、WBC、Plt、中心粒细胞比例、PT、INR、APTT、R值比较,差异无统计学意义(P>0.05)。两组一般资料GFR、结石CT值、Hb、D2聚体、PCT、IL-6、K值、MA值、angle角比较存在统计学差异(P<0.05)。经二元Logistic回归分析显示,Hb减少、K值下降、angle角上升是预测经皮肾镜碎石术患者术后出血的独立影响因素(P<0.05)。相关性分析显示,Hb与K值、R值呈正相关,与MA值、angle角负相关(r=0.508/0.391/-0.349/-0.548,P<0.05)。ROC曲线分析显示,K值的曲线下面积AUC值(0.707,P<0.05),约登指数0.416,敏感度89.50%,特异度52.10%;MA值的曲线下面积AUC值(0.618,P>0.05),约登指数0.303,敏感度89.50%,特异度40.80%;angle角的曲线下面积AUC值(0.720,P<0.05),约登指数0.430,敏感度89.50%,特异度53.50%;R值的曲线下面积AUC值(0.610,P>0.05),约登指数0.377,敏感度84.20%,特异度53.50%;联合指标的曲线下面积AUC值(0.696,P<0.05),约登指数0.384,敏感度94.70%,特异度43.70%。结论血栓弹力图指标可通过评估经皮肾镜碎石术患者凝血功�
Objective To analyze the correlation between thromboelastogram(TEG) index and postoperative bleeding in patients underwent percutaneous nephrolithotomy, thus providing evidence for clinical treatment and prevention. Methods The clinical data of 90 patients suffered from percutaneous nephrolithotomy were collected for a retrospective study. According to the presence or absence of bleeding, they were divided into non-bleeding group(n=71) and bleeding group(n=19).1) The clinical data, including gender, age, operation time, glomerular filtration rate(GFR), stone length, stone width, stone CT value, white blood cell count(WBC), hemoglobin(Hb), platelet count(Plt), neutrophil ratio, prothrombin time(PT), international normalized ratio(INR), activated partial thromboplastin time(APTT), D2 polymer, procalcitonin(PCT), interleukin-6(IL-6), and TEG indicators(R value, K value, MA value, and angle), of the bleeding group and the non-bleeding group were compared. 2) The risk factors of postoperative bleeding in patients underwent percutaneous nephrolithotomy were analyzed. 3) The K, MA, R value, angle and ROC curve of the combined index were analyzed. Results There was no significant difference in gender, age, operation time, stone length, stone width, WBC, Plt, neutrophil ratio, PT, INR, APTT, R value between the two groups(P>0.05). General data of the two groups, including GFR, CT value of stones, Hb, D2 polymer, PCT, IL-6, K value, MA value, and angle, were statistically different(P<0.05). Binary logistic regression analysis showed that the decrease of Hb and K value, and the increase of angle were independent factors in the prediction of postoperative bleeding in patients underwent percutaneous nephrolithotomy(P<0.05). Correlation analysis displayed that Hb was positively related to K and R value, and negatively correlated with MA value and angle(r=0.508/0.391/-0.349/-0.548, both P<0.05);ROC curve analysis indicated the AUC of K value:(0.707, P<0.05), 0.416 of Youden index, 89.50% of sensitivity, and 52.10% of specificit
作者
李宏
姚雄波
LI Hong;YAO Xiongbo(Urology Department,the People's Hospital of Jianyang,Jianyang 641400,China;Southwest Medical University)
出处
《中国输血杂志》
CAS
2021年第6期620-623,共4页
Chinese Journal of Blood Transfusion
关键词
血栓弹力图
经皮肾镜碎石术
出血
thromboelastogram(TEG)
percutaneous nephrolithotomy
bleeding
