Abstract: Objective To investigate the importance of thromboelastography (TEG) in the evaluation of hepatitis B liver cirrhosis associated with esophageal and gastric varicose bleeding. Methods A total of 40 patients with hepatitis B liver cirrhosis admitted to Xuzhou Central Hospital from February 2021 to February 2023 and 20 patients who underwent a healthy physical examination during the same period were included. The healthy physical examination population was included as a control group, and patients with hepatitis B cirrhosis were divided into a bleeding group (n=20) and a non-bleeding group (n=20). The bleeding group was randomly divided into group A (n=10) and group B (n=10), with group A and group B taking a routine coagulation test and a TEG test to guide blood transfusion respectively. The ROC curve was designed to compare the results of the TEG test with the index of agglutination function in the bleeding group, non-bleeding group and control group, and to analyze the equilibrium value of the results of the TEG test and conventional coagulation test, as well as the prognosis and dosage of the transfusion components of groups A and B. Results The platelet count (PLT) and fibrinogen (FIB) levels in the bleeding group and the non-bleeding group were significantly lower than those in the control group, while the levels of prothrombin time (PT), international normalized ratio (INR) and activated partial thromboplastin time (APTT) were significantly higher than those in the control group (P<0.05). The levels of PLT and FIB in the bleeding group were significantly lower than those in the non-bleeding group [PLT: (67.13±33.18) vs. (84.23±29.34) ×10⁹/L; FIB: (1.47±0.49) vs. (1.97±0.52) g/L, P<0.05]; The blood clot formation time (K) of the bleeding group and the non-bleeding group were significantly higher than those in the control group, and the coagulation angle (α) and maximum vibration radiation (MA) levels were significantly lower than those in the control group (P<0.05). The α angle and MA levels in the bleeding group [(45.45±5.79) deg and (40.71±5.25) mm, respectively] were significantly lower than those in the non-bleeding group [(51.34±5.14) deg and (48.46±6.08) mm, P<0.05], respectively; The area under the PLT, FIB, α angle and MA curve exceeded 0.5 (P<0.05), and the area under the α angle curve was the largest. The improvement rate of prognosis in group B was significantly higher than that of group A (100% vs. 60%), and the number of days of hospital stay was (9.12±1.02) d, which was significantly lower than that of group A (11.48±1.25) d (P<0.05); The dosage of red blood cells and plasma in group B [(3.14±0.67) U and (534.07±80.42) mL, respectively] was less than that of group A [(4.11±0.74) U and (617.18±90.51) mL], respectively, and the dosage of platelets and cryoprecipitate [(0.32±0.07) U and (33.48±6.25) U, respectively] was significantly greater than that of group A [(0.25±0.06) U and (28.12±5.02) U] (P<0.05), respectively]. Conclusion The TEG coagulation test can better guide the management of blood transfusion than traditional coagulation tests such as standard PT, PLT and INR, and has the highest diagnostic efficiency of α angular parameters. TEG can improve patient outcomes by providing accurate guidance for transfusion treatment.

Key words: Thromboelastography parameters, Hepatitis B cirrhosis, Gastrointestinal bleeding