Effects of thrombelastogram on preventing deep venous thrombosis and hemorrhage after surgery for patients with varicosity of lower extremities

Abstract

Objective To explore the effects of thrombelastogram (TEG) on preventing deep venous thrombosis (DVT) and hemorrhage after surgery for varicosity of lower extremities. Methods Totally 200 patients with varicosity of lower extremities who received exfoliation of great saphenous veins combined with transilluminated powered phlebectomy (TIPP) in a ClassⅢ Grade A hospital in Hebei Province from March 2016 to May 2017 by convenient sampling, and divided into the observation group (n=101) and the control group (n=99) according to the random number table. Patients in the observation group were evaluated with Caprini's DVT Assessment Model 24 hours before surgery. Patients who scored 3 or above received TEG monitoring 24 hours before surgery and on days 1, 3 and 7 post surgery, and received hierarchical interventions. Patients in the control group received conventional nursing care during the perioperative period, and empirical anticoagulation measures were taken based on the results of blood and coagulation routine examinations. Color Doppler ultrasonography was used to observe the incidence of DVT in both extremities in the patients one week post surgery, and the incidence of hemorrhage were also observed in patients in the two groups, including hemorrhage running out of dressings, incision bleeding and subcutaneous hematoma. Results DVT was found in 1 patient in the observation group (0.99%) and 8 patients in the control group (8.08%) ; hemorrhage running out of dressings was found in 3 patients in the observation group, incision bleeding in 2 patients and subcutaneous hematoma in 5 patients, while hemorrhage running out of dressings was found in 10 patients in the control group, incision bleeding in 9 patients and subcutaneous hematoma in 13 patients. There were statistical differences between the two groups (P<0.05) . Conclusions TEG dynamic monitoring combined with Caprini's DVT Assessment Model used in hierarchical interventions for patients with varicosity of lower extremities who receive exfoliation of great saphenous veins combined with TIPP reduces the incidence of DVT and hemorrhage, effectively avoids adverse events postoperatively, and ensures the patients' safety. Key words: Deep venous thrombosis; Varicosity; Postoperative hemorrhage; Thrombelastogram