Correlation Between Thrombus Elasticity Index And Postoperative Hemorrhage In Coronary Artery Bypass Grafting

Objective: To investigate the correlation between thrombus elasticity index and postoperative bleeding in patients who were undergoing off-pump coronary artery bypass grafting.Methods: Selected 130 patients who received OPCABG inthe Second Hospital of Hebei Medical University and analyzed.According to the total amount of drainage in 24 hours after surgery,the patients were divided into 2 groups: the drainage volume in 24 hours after operation <500ml was group A,n=80;the drainage volume in 24 hours after operation?500ml was group A,n=50.The patients took TEG monitoring before heparinization,5 min after heparinization and 5 min after protamine neutralization,and recorded the MA,R,K,Angle.Then did the satatistical analysis of the general behavior and bleeding,the TEG indicators between the two groups were compared for correlation analysis and receiver operating characteristic curve analysis and the conclusions were drawn.Results:1.There was a statistically difference between intraoperative blood loss and cryoprecipitate input between group A and group B(P<0.05).There were no significant differences in basic data,preoperative complications,and operation time,et al.(P>0.05).2.The drainage volume at 24 h after operation in group A and group B was statistically significant(P<0.05).3.There were significant differences in the TEG indexes of three time periods between the A group and the B group(P<0.05).4.Spearman correlation analysis found that the MA values of the three time periods were negatively correlated with the drainage volume at 24 hours after operation,and the MA value after heparinization was the most correlated with the drainage volume at 24 hours after surgery(r=-0.352,P<0.05).5.The receiver operating characteristic curve analysis showed that the MA value after heparinization was 70.6mm as the best critical point,the sensitivity was 46.3%,and the specificity was 80%.Conclusions: TEG-MA value predicts postoperative bleeding with greater significance;TEG-MA value after heparinization has the greatest negative correlation with drainage volume at 24 hours after surgery,and below 70.6 mm indicates that the patient may have a drainage volume greater than or equal to 500 ml at 24 hours after surgery.