Thromboelastogram index and postoperative bleeding in patients underwent percutaneous nephrolithotomy
10.13303/j.cjbt.issn.1004-549x.2021.06.014
- VernacularTitle:血栓弹力图与经皮肾镜取石术患者术后出血的相关性及临床价值
- Author:
Hong LI
1
,
2
;
Xiongbo YAO
1
Author Information
1. Urology Department, the People′s Hospital of Jianyang, Jianyang 641400, China
2. Southwest Medical University
- Publication Type:Journal Article
- Keywords:
thromboelastogram(TEG);
percutaneous nephrolithotomy;
bleeding
- From:
Chinese Journal of Blood Transfusion
2021;34(6):620-623
- CountryChina
- Language:Chinese
-
Abstract:
【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 specificity; the AUC of MA value: (0.618, P>0.05), 0.303 of Youden index, 89.50% of sensitivity, and 40.80% of specificity; AUC value of angle: (0.720, P<0.05), 0.430 of Youden index, 89.50% of sensitivity, and 53.50% of specificity; AUC of R value: (0.610, P>0.05), 0.377 of Youden index, 84.20% of sensitivity, and 53.50% of specificity; AUC value of the combined index: (0.696, P<0.05), 0.384 of Youden index, 94.70% of sensitivity, and 43.70% of specificity. 【Conclusion】 TEG indicators can assess the coagulation function of patients underwent percutaneous nephrolithotomy, predict the risk of postoperative bleeding, and help guide clinical postoperative treatment.
