Application Of Thrombelastography In Perioperative Period Of Lung Cancer Patients

Objective: To investigate the thromboelasto gram(TEG) in the application value in patients with lung cancer during perioperative period.Methods: From September 2013 to September 2014, Department of Cardiothoracic Surgery of Qingdao Municipal Hospital treated patients with lung cancer needing operation for 28 cases.The total cases were divided into two groups according to the existence of the postoperative complication of Deep Venous Thrombosis(DVT):DVT group for 11 cases and Un-Deep Vein Thrombosis(UDVT) group for 17 cases.There were nine male and two female patients,aging from 35 to 67 in the DVT group.And there were fourteen male and three female patients,aging from 35 to 64 in the UDVT group. The samples collected from the patients were all intermediate or advanced lung cancer by the histopathologic diagnosis. Central venous blood specimens from all the patients needing operation were drawn before operation(T0)、intraoperative 3h(T1)、 first day after operation(T2), third day after operation(T3) respectively. Another 20 central venous blood specimens from healthy people were also drawn respectively as contrast group. The four indicators of coagulation for all the samples above are Thrombintime(TT)、Prothrombin time(PT)、 Activated Partial Thromboplastin Time(APTT)、Fibrinogen(Fib) and Thromboelasto Gram(TEG),the values of which are the reaction time(R value) 、the coagulation time(K value)、thrombosis maximum amplitude(MA value) and fibrinolytic index(LY30).The results are analyzed by SPSS 15.0.Results: It was found in the coagulation routine test that the detection data for TT、APTT and Fib from lung cancer group(DVT+UDVT) and the contrast group were not statistically significant.But PT of lung cancer group prolonged,which showed statistically significant difference(P<0.05). TEG results showed that T0 point、R and K value became significantly shortened and MA value decreased(P<0.05) in the DVT and UDVT preoperative patients compared with the contrast group; R and K value increased(P<0.05) and the MA value decreased(P<0.05) in the UDVT patients compared with T0 point in the preoperative patients; R and K value increased and MA value between T2 and T3 decreased,in UDVT patients compared with DVT patient which showed statistically significant(P<0.05);fibrinolysis index LY30 value from UDVT group in T1、T2 and T3 increased compared with T0,which also showed statistically significant(P<0.05);the value increased in T1、T2 and T3 compared with DVT group, the difference was statistically significant(P<0.05).Conclusion: Pathological hypercoagulabale state exists in the preoperative lung cancer patients but the healthy people; In the intraoprative and postoperative patients of DVT group, thrombosis happened faster, platelet function enhanced to the development of high coagulation state especially in the operation, and increased the risk of deep vein thrombosis; Fibrinolysis enhanced while the coagulation status was needed in the intraoperative patients of UDVT. And coagulation in perioperative thoracic surgery lung cancer patients showed high coagulation state 、fibrinolysis and other complex conditions; The thromboelasto gram(TEG) can successfully monitor the coagulation. The probability of the occurrence of DVT after operation can be judged according to the values of TEG in order to reduce the risk of deep vein thrombosis by human intervention as soon as possible.