实用医学杂志 ›› 2022, Vol. 38 ›› Issue (17): 2226-2230.doi: 10.3969/j.issn.1006⁃5725.2022.17.020

• 医学检查与临床诊断 • 上一篇    下一篇

血栓弹力图在子宫内膜异位症中的应用价值 

熊翔鹏1 夏雷震2 艾小燕1    

  1. 江西省妇幼保健院1 妇科,2 辅助生殖科(南昌330006)

  • 出版日期:2022-09-10 发布日期:2022-09-10
  • 通讯作者: 艾小燕 E⁃mail:86487629@qq.com
  • 基金资助:

Application value of thromboelastograph for endometriosis

XIONG Xiangpeng*,XIA Leizhen,AI Xiaoyan.   

  1. Department of Gynaecology,Jiangxi Maternal and Child Health Hospital,Nanchang 330006,China

  • Online:2022-09-10 Published:2022-09-10
  • Contact: AI Xiaoyan E⁃mail:86487629@qq.com

摘要:

目的 探讨血栓弹力图检测与子宫内膜异位症(EMs)的相关性及在其诊治中的临床预测 价值。方法 收集手术确诊为 EMs 316 例患者为内异组,选取同期手术确诊为其他卵巢良性肿瘤的 131 例患者为对照组,评估 TEG 指标对 EMs 的诊断价值及与各项临床病理参数的相关性。结果 内异组 患者 TEG 检测的 R 值、K 值较对照组下降,α 角、MA 值、CI 值升高,差异均有统计学意义(P < 0.05),且 R 值、α 角、MA 值为 EMs 发生的独立影响因素(P < 0.01),α 角的曲线下面积(AUC)为 0.706,MA AUC 0.730。随着内异症 ASRM 期别的上升,α 角增大、MA 值升高(P < 0.01);无⁃轻度盆腔粘连者较中重度粘连 K 值更高,α 角及 MA 值更低(P < 0.05);无⁃部分子宫直肠凹陷封闭者较完全封闭者 α 角及 MA 值更低, 囊肿≤ 5 cm 患者 α 角、MA 值、CI 值均小于囊肿> 5 cm 者,差异均有统计学意义(P < 0.01)。有无痛经患者 TEG 指标差异无统计学意义(P > 0.05)。结论 TEG 指标变化与 EMs 的发生发展密切相关,有助于早期诊 断及预后判别,并为患者病情的评估、手术难度的预估及治疗方案的制定提供参考依据。

关键词:

子宫内膜异位症, 凝血, 血栓弹力图, 卵巢良性肿瘤

Abstract:

Objective To investigate the correlation between thromboelastograph andendometriosis and its clinical predictive value. Methods A total of 316 patients diagnosed with endometriosis were included in the endometriosis group,and 131 cases of patients diagnosed with other benign ovarian tumors were selected as the control group. The predictive value of the occurrence and development of endometriosis and the correlation of various clinicopathological parameters were evaluated. Results Compared with the control group,the R value and K value of patients in the endometriosis group were decreased,while α Angle,MA value and CI value were increased,the differences were statistically significant(P < 0.05),and R value,α Angle and MA value were independent influ⁃ encing factors for the occurrence of endometriosis(P < 0.01). The AUC of α Angle was 0.706. The AUC of MA value was 0.730. With the increase of ASRM stage,α Angle and MA value increased(P < 0.01). The K value of patients with mild pelvic adhesions was higher than those with moderate and severe pelvic adhesions,but the α Angle and MA values were lower,the differences were statistically significant(P < 0.05). The α Angle and MA values of patients without or partially closed uterine rectum depression were lower than those of patients with com⁃ plete rectum depression,the α Angle,MA and CI values of patients with cysts less than or equal to 5 cm were lower than those of patients with cysts more than 5 cm(P < 0.01). No significant difference was noted in TEG index between patients with and without dysmenorrhea. Conclusion The changes of TEG indicators were closely related to the occurrence and development of EMs,which could be used as one of the indicators to predict the occurrence and development of EMs. The detection of TEG in patients was helpful for early diagnosis and prognosis discrimina⁃ tion,and provided reference for the evaluation of patients′ condition,the prediction of surgical difficulty and the formulation of treatment plan.

Key words:

endometriosis, coagulation, thromboelastograph, benign ovarian tumor