Kawamoto Shuji, Matsumoto Tsuguhiro, Chiwata Yohei, Takeda Chikashi, Kusudo Eriko, Egi Moritoki
Department of Anesthesia, Kyoto University Hospital, 54 Shogoin- Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
JA Clin Rep. 2025 May 17;11(1):27. doi: 10.1186/s40981-025-00789-6.
Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by increased platelet count and risk of thrombosis and bleeding, which necessitates careful perioperative management. However, there are no standardized guidelines for perioperative antithrombotic therapy, and optimal preoperative evaluation remains unclear. In this report, we evaluate the utility of thromboelastography (TEG®6 s) for assessing coagulation and platelet function in ET patients undergoing surgery.
Four ET patients (platelet counts: 289,000-833,000/µL) underwent thromboelastography at anesthesia induction. Two had normal coagulation, while two had a hypercoagulable state undetected by conventional tests. Hypercoagulability was observed in patients who discontinued anticoagulants or antiplatelets preoperatively.
Thromboelastography identified thrombotic tendencies not evident with conventional coagulation tests, suggesting its potential for perioperative risk assessment in ET patients. This approach may improve individualized coagulation management beyond use of platelet counts and standard tests. Further studies are needed to establish the role of thromboelastography in optimizing perioperative antithrombotic strategies.
原发性血小板增多症（ET）是一种骨髓增殖性肿瘤，其特征为血小板计数增加以及存在血栓形成和出血风险，这就需要进行仔细的围手术期管理。然而，目前尚无围手术期抗栓治疗的标准化指南，最佳术前评估仍不明确。在本报告中，我们评估了血栓弹力图（TEG®6s）在评估接受手术的ET患者凝血和血小板功能方面的效用。
4例ET患者（血小板计数：289,000 - 833,000/µL）在麻醉诱导时接受了血栓弹力图检查。2例凝血功能正常，而2例存在常规检查未检测到的高凝状态。术前停用抗凝剂或抗血小板药物的患者出现了高凝状态。
血栓弹力图可识别出常规凝血检查未显示的血栓形成倾向，提示其在ET患者围手术期风险评估中的潜力。这种方法可能会改善超出血小板计数和标准检查范围的个体化凝血管理。需要进一步研究以确定血栓弹力图在优化围手术期抗栓策略中的作用。
