CAJ | 학술논문

目的：探讨老年患者腰椎围手术期血栓弹力图（thrombelastogram, TEG）的特点，为老年腰椎手术患者深静脉血栓的预防提供参考。方法30例纳入本研究的老年腰椎手术患者，分别于术前（手术当天麻醉前T0d）、术后第1天（T1d）、术后第3天（T3d）、术后1周（T1w）、术后2周（T2w）清晨空腹静脉采血行TEG普通检测。结果 T0d组血栓弹力图正常，T1d、T3d、T1w和T2w分别与T0d比较：反应时间（R）和凝固时间(K)缩短，凝固角（Angle）增大，差异有统计学意义（P＜0.05或P＜0.01），最大血块强度（MA）及凝血块强度（G）变化不明显。T1d、T3d、T1w和T2w组间比较，差异无统计学意义（P＞0.05）。结论观察组的血栓弹力图在术前未见异常，术后均呈现高凝状态，凝血因子活性及纤维蛋白原功能均增强，且术后1周左右高凝状态达到峰值，所以，要积极预防在此期间血栓形成。
목적：탐토노년환자요추위수술기혈전탄력도（thrombelastogram, TEG）적특점，위노년요추수술환자심정맥혈전적예방제공삼고。방법30례납입본연구적노년요추수술환자，분별우술전（수술당천마취전T0d）、술후제1천（T1d）、술후제3천（T3d）、술후1주（T1w）、술후2주（T2w）청신공복정맥채혈행TEG보통검측。결과 T0d조혈전탄력도정상，T1d、T3d、T1w화T2w분별여T0d비교：반응시간（R）화응고시간(K)축단，응고각（Angle）증대，차이유통계학의의（P＜0.05혹P＜0.01），최대혈괴강도（MA）급응혈괴강도（G）변화불명현。T1d、T3d、T1w화T2w조간비교，차이무통계학의의（P＞0.05）。결론관찰조적혈전탄력도재술전미견이상，술후균정현고응상태，응혈인자활성급섬유단백원공능균증강，차술후1주좌우고응상태체도봉치，소이，요적겁예방재차기간혈전형성。
Objective To observe the change of perioperative thrombelastogram(TEG) in elderly patients with lum-bar spine surgery, and provide reference for deep vein thrombosis prevention in elderly patients with lumbar spine surgery. Methods Thirty elderly patients with lumbar spine surgery were enrolled into the study. Fasting venous blood samples were collected during preoperative (the day of surgery before anesthesia, T0d)、postoperative day 1 (T1d)、postoperative day 3(T3d)、postoperative week 1(T1w)、postoperative week 2(T2w).The thrombelastogram(TEG) was measured for all blood samples. Results The thrombelastogram of T0d group was normal.The reaction time (R) and clotting time (K) of T1d, T3d, T1w and T2w were shortened ,and the coagulation angle (Angle) increased with significant difference when compared with T0d(P<0.05 or P<0.01) , the largest clot strength (MA) and clot strength (G) did not change significant-ly. The difference of MA between T1d, T3d, T1w and T2w group, was not significant (P>0.05). Conclusion The throm-belastograms of the observation group is normal in the preoperative period, but and the postoperative period presents a hy-percoagulable state, The activity and functions of fibrinogen clotting factors are enhanced. Hypercoagulable state reach its peak level at about 1 week after surgery, so we must actively prevent thrombosis during this period.