Application of thromboelastography in the prediction of deep vein thrombosis after high-energy ankle injury surgery / 中国基层医药

ABSTRACT

Objective:To analyze the application value of thromboelastography (TEG) in the prediction of lower limb deep vein thrombosis (DVT) after high-energy ankle injury surgery.Methods:The clinical data of 62 patients undergoing high-energy ankle injury surgery who received treatment in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to December 2021 were retrospectively analyzed. Based on the occurrence of lower limb DVT, the patients were divided into a control group (without lower limb DVT, n = 42) and an observation group (with lower limb DVT, n = 20). The conventional coagulation function indicators and TEG parameters were compared between the two groups. The receiver operating characteristic (ROC) curves were used to investigate the value of classic coagulation function indicators and TEG parameters in the prediction of lower limb DVT after high-energy ankle injury surgery. Results:The activated partial thromboplastin time in the observation group was (33.29 ± 3.40) seconds, which was significantly shorter than (35.66 ± 3.36) seconds in the control group ( t = 2.59, P < 0.05). The levels of fibrinogen and D-dimer in the observation group were (3.83 ± 0.46) g/L and (1.77 ± 0.43) g/L, respectively, which were significantly higher than (3.47 ± 0.51) g/L and (1.56 ± 0.35) g/L, respectively, in the control group ( P = -2.68, -.05, both P < 0.05). Prothrombin time and thrombin time showed no significant differences between the two groups (both P > 0.05). Coagulation reaction time and cell agglutination formation time in the observation group were (3.80 ± 0.83) minutes and (3.38 ± 0.51) minutes, respectively, which were significantly lower than (4.49 ± 1.21) minutes and (3.82 ± 0.55) minutes in the control group ( t = 2.30, 2.96, both P < 0.05). The maximum clot strength and coagulation rate (α angle) in the observation group were (78.69 ± 9.22) mm and (83.37 ± 9.30) °, respectively, which were significantly greater than (68.33 ± 9.10) mm and (71.25 ± 8.35) ° in the control group ( t = -4.17, -5.15, both P < 0.05). The ROC curve analysis found that the area under the ROC curve describing the prediction of combined indexes for lower limb DVT was 0.983, which was significantly greater than the area under the ROC curve describing the prediction of a single index for lower limb DVT (all P < 0.05). Conclusion:Activated partial thromboplastin time, fibrinogen, D-dimer, coagulation reaction time, red blood cell agglutination formation time, maximum clot strength, and α angle are significantly different between patients with DVT in the lower limb after surgery for an ankle injury and those without DVT. The combination of these indicators can serve as the basis for preventing and treating thrombosis in patients after high-energy ankle injury surgery, demonstrating remarkable practical advantages.