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首页> 外文期刊>The American Journal of Surgery >The international normalized ratio overestimates coagulopathy in patients after major hepatectomy
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The international normalized ratio overestimates coagulopathy in patients after major hepatectomy

机译：国际标准化比率高估了大肝切除术后患者的凝血病

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Background: The International Normalized Ratio (INR) is commonly used to guide therapy after hepatectomy. We hypothesized that the use of thrombelastography (TEG) would demonstrate a decreased incidence of hypocoagulability in this patient population. Methods: Seventy-eight patients were prospectively enrolled before undergoing hepatectomy. INR, TEG, and coagulation factors were drawn before incision, postoperatively, and on postoperative days 1, 3, and 5. Results: Patients demonstrated an elevated INR at all postoperative time points. However, TEG demonstrated a decreased R value postoperatively, with subsequent normalization. Other TEG measurements were equivalent to preoperative values. All procoagulant factors save factor VIII decreased postoperatively, with a simultaneous decrease in protein C. Conclusions: TEG demonstrated a brief hypercoagulable state after major hepatectomy, with coagulation subsequently normalizing. The INR significantly overestimates hypocoagulability after hepatectomy and these data call into question current practices using the INR to guide therapy in this patient population.
机译：背景：国际标准化比率（INR）通常用于指导肝切除术后的治疗。我们假设使用血栓弹力描记术（TEG）可以证明该患者人群低凝性发生率降低。方法：前瞻性入组了78例肝切除术患者。在切开之前，术后以及术后第1、3和5天绘制INR，TEG和凝血因子。结果：患者在所有术后时间点均显示INR升高。但是，TEG术后R值降低，随后恢复正常。其他TEG测量值等同于术前值。术后除VIII因子外，所有促凝血因子均降低，同时蛋白C同时降低。结论：TEG在大肝切除术后表现出短暂的高凝状态，凝血随后恢复正常。 INR显着高估了肝切除术后的低凝性，这些数据使目前使用INR指导该患者人群治疗的实践受到质疑。

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