摘要
目的:对比研究腹腔镜胃癌手术与开腹手术对患者凝血功能的影响。方法:将70例患者分为腹腔镜胃癌手术组(腹腔镜组)及开腹手术组(开腹组)各35例,分别于术前、手术结束时及术后24h,用凝固法检测凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(FIB),用INR法计算凝血酶原国际标准化值(INR);用酶联免疫吸附双抗体夹心法(ELISA)定量测定血浆中D-二聚体(D-D)含量。结果:两组手术结束时及术后24hAPTT及INR与术前无显著差异;腹腔镜组FIB及D-D均显著升高,差异有统计学意义(P<0.05),开腹组FIB手术结束时虽升高,但差异无统计学意义;术后24h升高差异有统计学意义,术后24h两组PT明显降低,但组间无显著差异。结论:腹腔镜胃癌手术及开腹手术均可使患者血液呈高凝状态,增加了术后血栓发生的风险,且腹腔镜胃癌手术对患者凝血功能的影响更大,围手术期应积极采取预防措施。
Objective ：To investigate the difference of laparoscopic surgery and laparotomy for gastric cancer on blood coagulation. Methods：Blood coagulation was determined by detecting the values of the PT,APTT, FIB and INR,and enzyme linked immunosorbent assay （ELISA） was used to detect the value of D-D at pre-operation,post-operation and 24th hour after operation in 35 patients under laparoscopic surgery or laparotomy for gastric cancer respectively. Results：Compared with pre-operation,no change in the values of APTT and INR at the end of operation and 24th hour post-operation could be observed in both groups. The values of FIB and D-D markedly increased at the end of operation and 24th hour post-operation in laparoseopy groups,and there were significant difference （P 〈 0.05 ）. The change of D-D in open group was similar to open group, while FIB increased when operations finished （ P 〉 0.05 ） and 24h after operation （P 〈 0.05）. The values of PT decreased sharply at 24th hour post-operation in the two groups, but there was no significant difference between 2 groups. Conclusions：The effect of laparoscopic surgery appears to make coagulation function vary more significantly than laparotomy, which would increase the incidence of deep vein thrombosis. So it is requisite to perform the treatment of anti-coagulation on the patients with laparoscopic surgery.
出处
《腹腔镜外科杂志》
2009年第9期666-668,共3页
Journal of Laparoscopic Surgery
关键词
胃肿瘤
腹腔镜术
剖腹术
血液凝固
对比研究
Stomach neoplasms
Laparoscopy
Laparotomy
Blood coagulation
Comparative study
