[1]朱敏基,包咏龙,杨平,等.血栓弹力图对结直肠癌患者术后发生静脉血栓栓塞症的预测价值[J].陕西医学杂志,2026,(8):1058-1063.[doi:DOI:10.3969/j.issn.1000-7377.2026.08.007]
　ZHU Minji,BAO Yonglong,YANG Ping,et al.Predictive value of thromboelastography for postoperative venous thromboembolism in patients with colorectal cancer[J].,2026,(8):1058-1063.[doi:DOI:10.3969/j.issn.1000-7377.2026.08.007]
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血栓弹力图对结直肠癌患者术后发生静脉血栓栓塞症的预测价值

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2026年8期
页码:
1058-1063
栏目:
临床研究
出版日期:
2026-08-05

文章信息/Info

Title:
Predictive value of thromboelastography for postoperative venous thromboembolism in patients with colorectal cancer
作者:
朱敏基1; 2; 包咏龙2; 杨平2; 郑英楷1; 2; 梁文竞2; 李旺林1; 2
（1.广东医科大学第一临床医学院，广东 湛江 524023；2.广州市第一人民医院，广东 广州 510180）
Author(s):
ZHU Minji1; 2; BAO Yonglong2; YANG Ping2; ZHENG Yingkai1; 2; LIANG Wenjing2; LI Wanglin1; 2
(1.The First School of Clinical Medicine of Guangdong Medical University,Zhanjiang 524023,China;2.Guangzhou First People’s Hospital,Guangzhou 510180,China)
关键词:
结直肠癌; 静脉血栓栓塞症; 血栓弹力图; 凝血功能; 影响因素; 预测价值
Keywords:
Colorectal cancer; Venous thromboembolism; Thromboelastography; Coagulation function; Influencing factors; Predictive value
分类号:
R 735.3
DOI:
DOI:10.3969/j.issn.1000-7377.2026.08.007
文献标志码:
A
摘要:
目的：探讨结直肠癌（CRC）患者术后发生静脉血栓栓塞症（VTE）的影响因素及血栓弹力图（TEG）参数对CRC术后发生VTE的预测价值。方法：选取接受CRC根治术治疗的112例CRC患者，根据术后4周内是否发生VTE分为对照组（未发生VTE，92例）和观察组（发生VTE，20例）。比较两组患者一般资料、围术期相关指标及术前凝血功能和TEG参数。多因素Logistic回归分析CRC术后发生VTE的危险因素。以受试者工作特征（ROC）曲线分析TEG参数对CRC术后发生VTE的预测效能。结果：观察组男性、年龄≥60岁、合并高血压患者比例高于对照组（均P<0.05）。观察组手术时间、术中出血量、术后制动时间、血浆黏稠度、纤维蛋白原（FIB）、D-二聚体、血栓最大振幅（MA值）、α-Angle（α角）、凝血综合指数（CI值）高于对照组，凝血反应时间（R值）、凝血形成时间（K值）低于对照组（均P<0.05）。性别、年龄、合并高血压、手术时间、术中出血量、术后制动时间、血浆黏稠度、FIB、D-二聚体、R值、K值、CI值为CRC患者术后发生VTE的独立影响因素（均P<0.05）。R值、K值、CI值联合预测VTE发生的曲线下面积（AUC）高于单一指标预测的AUC（均P<0.05）。结论：TEG参数R值、K值、CI值是CRC患者术后发生VTE的独立影响因素，三者联合可用于CRC术后VTE的预测。
Abstract:
Objective:To investigate the influencing factors of postoperative venous thromboembolism (VTE) in patients with colorectal cancer (CRC) and the predictive value of thromboelastography (TEG) parameters for postoperative VTE in CRC patients.Methods:A total of 112 CRC patients who underwent radical surgery for CRC were selected.According to whether VTE occurred within 4 weeks after surgery,they were divided into control group (without VTE,92 cases) and observation group (with VTE,20 cases).The general clinical data,perioperative parameters,preoperative coagulation function and TEG parameters were compared between the two groups.Multivariate Logistic regression was used to analyze the risk factors of postoperative VTE in CRC patients.ROC curve was used to analyze the predictive efficacy of TEG parameters for postoperative VTE in CRC patients.Results:The proportions of male patients,patients aged≥60 years and patients with hypertension in the observation group were higher than those in the control group (all P<0.05).The operation time,intraoperative blood loss,postoperative immobilization time,plasma viscosity,fibrinogen (FIB),D-dimer,maximum amplitude (MA value),α-Angle and coagulation index (CI value) in the observation group were higher than those in the control group,while the reaction time (R value) and clot formation time (K value) were lower than those in the control group (all P<0.05).Gender,age,hypertension comorbidity,operation time,intraoperative blood loss,postoperative immobilization time,plasma viscosity,FIB,D-dimer,R value,K value and CI value were independent influencing factors for postoperative VTE in CRC patients (all P<0.05).The AUC of combined prediction of VTE by R value,K value and CI value was higher than the AUC of single indicator prediction (all P<0.05).Conclusion:TEG parameters R value,K value and CI value are independent influencing factors for postoperative VTE in CRC patients,and the combination of the three can be used for the prediction of postoperative VTE in CRC.

参考文献/References:

[1]姚岚,郭菲,宋莉,等.血清LBP、presepsin、LDH联合检测对结直肠癌术后患者肠梗阻发生的预测价值[J].陕西医学杂志,2025,54(6):800-803,824.
[2]RUGGERI S,PIZZITOLA B,LAFFRANCHI M,et al.TNF-α deficiency underlies NK cell dysfunction in colorectal cancer[J].Oncoimmunology,2026,15(1):2636311.
[3]WIRASISYA D G,KINCSES A,SETIAWANSYAH A,et al.Phytochemical study of Homalanthus giganteus:Isolation,antiproliferative activity,and computational mechanistic insights of tigliane diterpenes against colorectal cancer[J].Pharm Biol,2026,64(1):312-333.
[4]TAPIAINEN V V,SIRNIO P,KARJALAINEN H,et al.Impact of stromal maturity and proportion on prognosis and immune landscape in colorectal cancer[J].Ann Med,2026,58(1):2606512.
[5]马娜,丁荣,和苗,等.ABO基因多态性与结直肠癌患者静脉血栓栓塞症发生关系研究[J].临床军医杂志,2026,54(1):94-97,101.
[6]李舸,宋博,李杰,等.结直肠癌根治术后并发静脉血栓栓塞的相关危险因素分析[J].肿瘤预防与治疗,2020,33(10):870-876.
[7]李伟,张乐,汪文杰,等.6种血栓评估量表对胃肠道肿瘤患者深静脉血栓形成的预测价值评估[J].中国普外基础与临床杂志,2024,31(1):40-44.
[8]任鑫,张佳宇,张美霞.老年髋部骨折患者围术期深静脉血栓形成预防和管理的最佳证据研究[J].空军军医大学学报,2025,46(2):236-241.
[9]吕益萍,陈良,鲍丽伊,等.血栓弹力图联合凝血功能检测预测妇科恶性肿瘤围手术期静脉血栓栓塞症的临床价值[J].广西医科大学学报,2025,42(3):408-414.
[10]中华医学会外科学分会血管外科学组.深静脉血栓形成的诊断和治疗指南(第三版)[J].中华普通外科杂志,2017,32(9):605-616.
[11]中华医学会心血管病学分会肺血管病学组.急性肺栓塞诊断与治疗中国专家共识(2015)[J].中华心血管病杂志,2016,44(3):197-211.
[12]JHNK C,JARBL D E,STRE L M S,et al.Healthcare seeking with colorectal cancer symptoms-results from two Danish population-based surveys in 2012 and 2022[J].Scand J Prim Health Care,2026,44(1):1-14.
[13]NKENGUYE W,AMSI P,LODHIA J.Sigmoid diverticulitis mimicking colorectal cancer:A case report[J].Radiol Case Rep,2026,21(5):1936-1941.
[14]JOVIC ZLATOVIC J,BEVANDA M,TELESMANIC DOBRIC V,et al.Association of cancer-associated venous thromboembolism with the primary site of colorectal cancer,with respect to KRAS/NRAS/BRAF mutations[J].Biomedicines,2026,14(2):312.
[15]冬颖,郭展立,王媛,等.结直肠癌相关静脉血栓栓塞研究进展[J].内蒙古医科大学学报,2025,47(5):551-556,560.
[16]杨志刚,任颖,张洁.血栓弹力图与常规凝血相关指标诊断肿瘤术后产生深静脉血栓的价值研究[J].系统医学,2024,9(16):1-4.
[17]戚央聪,王磊,周薇,等.血栓弹力图与常规凝血指标对结直肠癌的预后价值[J].中国卫生检验杂志,2020,30(21):2631-2633,2636.
[18]宁军,龚浩,丁超,等.血栓弹力图在评估晚期结直肠癌患者凝血功能中的临床应用价值[J].检验医学与临床,2021,18(14):2043-2046.
[19]朱艳玲,哈力旦·加马力丁,刘芳,等.凝血指标联合血栓弹力图指标对缺血性脑卒中患者复发的预测价值研究[J].实用心脑肺血管病杂志,2023,31(4):35-39.
[20]曾进龙,王璟,温国华,等.血栓弹力图参数在结肠癌术后并发高危静脉血栓栓塞症的预测价值[J].临床消化病杂志,2024,36(5):337-340.
[21]王雪星,陈春梅,何媛,等.血栓弹力图和凝血指标预测肿瘤相关静脉血栓栓塞症的价值[J].检验医学,2024,39(5):491-496.
[22]葛娇,陈敏,上官志敏,等.血栓弹力图联合血D-二聚体对弥漫大B细胞淋巴瘤患者并发下肢静脉血栓的预测[J].中国实验血液学杂志,2025,33(6):1623-1628.
[23]郭俊芳,肖华,李志婷,等.血栓弹力图参数、纤维蛋白(原)降解产物水平对结直肠癌并发静脉血栓栓塞症的预测价值[J].临床研究,2025,33(9):127-129,133.
[24]党元娜,敬蕾,周晓永.结直肠癌根治术后并发静脉血栓栓塞的危险因素分析[J].实用癌症杂志,2021,36(6):989-991.
[25]吴纪珍,齐咏,郭亚丽,等.内皮型一氧化氮合酶基因多态性与静脉血栓栓塞症相关性的荟萃分析[J].临床心血管病杂志,2018,34(5):498-501.
[26]IVASCU R,TORSIN L I,HOSTIUC L,et al.The surgical stress response and anesthesia:A narrative review[J].J Clin Med,2024,13(10):3017.
[27]李继红,王博.结直肠癌患者术后并发静脉血栓栓塞的影响因素分析[J].血栓与止血学,2020,26(2):278-279.
[28]HEIDARI Z,NAEIMZADEH Y,FALLAHI J,et al.The role of tissue factor in signaling pathways of pathological conditions and angiogenesis[J].Curr Mol Med,2024,24(9):1135-1151.
[29]陈宋林,曲军,黄聪,等.泌尿外科腹腔镜术后发生静脉血栓栓塞症的危险因素及其预测模型[J].解放军医学杂志,2025,50(6):721-727.

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备注/Memo

备注/Memo:
广东省基础与应用基础研究基金资助项目（2021B1515420004）
更新日期/Last Update: 2026-08-13