摘要
目的:探讨妇科盆腔术后下肢静脉血栓患者凝血功能变化及其临床意义。方法:采用ACL-TOP全自动血凝分析仪测定30例妇科盆腔术后下肢深静脉血栓患者,其中23例妇科恶性肿瘤患者(宫颈癌9例、卵巢癌6例、子宫内膜癌8例),5例子宫肌瘤患者、1例腺肌瘤、1例输卵管妊娠及58例妇科盆腔术后没有发生下肢深静脉血栓患者(其中妇科恶性肿瘤40例、子宫肌瘤18例)的血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆凝血酶时间(TT)、血浆纤维蛋白原含量(FIB)和D-二聚体(D-dimer)水平并与50例正常健康体检者进行比较。结果:妇科盆腔术后下肢静脉栓塞的患者术前和妇科盆腔术后未出现下肢静脉栓塞的患者术前FIB、D-dimer水平与正常体检者相比均明显增高,差异有统计学意义(P<0.01〉,妇科盆腔术后下肢深静脉栓塞的患者术前与术后未发生栓塞的患者术前D-dimer相比明显增高,差异有统计学意义(P<0.05),而PT、APTT、TT水平与正常健康体检者和妇科盆腔术后没有发生下肢静脉栓塞的患者相比差异无统计学意义(P>0.05)。妇科盆腔术后发生深静脉栓塞的患者24 h后与未发生深静脉栓塞的患者24 h后及对照组的FIB、D-dimer相比均明显增高,差异有统计学意义(P<0.01),而PT、APTT、TT水平差异无统计学意义(P>0.05)。临床经抗凝、溶栓、抗炎治疗后,患者均治愈,无并发症发生。患者恢复后查凝血功能显示PT、APTT、TT、Fib、D-dimer与正常体检者之间差异无统计学意义(P>0.05)。结论:凝血功能检测特别是FIB、D-dimer检测对于妇科盆腔术后并发下肢深静脉血栓患者的实验室检查有重要的作用,可用于妇科盆腔术后并发下肢深静脉血栓的早期预测,对于妇科盆腔术后并发下肢深静脉患者的治疗、恢复程度也有一定的指导作用。
Objective： To explore the change and clinical significance of coagulation function in patients with lower extremity deep venous thrombosis （LEDVT） after gynecological pelvic surgery. Methods： ACL - TOP automated coagulation analyzer was used to detect plasma prothrombin times （PT） , activated partial thromboplastin times （AtrFT） , plasma thrombin times （TT） , plasma fibrinogeu （ FIB ） concentrations, and D - dimer levels in 30 patients with LEDVT after gynecological pelvic surgery （ including 9 patients with cervical cancer, 6 patients with ovarian cancer, 8 patients with endometrial cancer, 5 patients with hysteromyoma, one patient with adenomyoma, and one patient with tubal pregnancy） and 58 patients without LEDVT （including 40 patients with gynecological malignant tumor and 18 patients with hysteromyoma） after gynecological pelvic surgery, then the results were compared with those of normal women （control group） after physical examination. Results： Before operation, FIB concentrations and D - dimer levels in the patients with LEDVT after gynecological pelvic surgery and the patients without LEDVT after gynecological pelvic surgery were statistically significantly higher than those in control group （ P 〈0. 01 ） . Before operation, the level of D - dimer in the patients with LEDVT after gynecological pelvic surgery was statistically significantly higher than that in the patients without LEDVT after gynecological pelvic surgery （P 〈 0.05） . Before operation, there were no statistically significant differences in the levels of PT, APTT and TT between the patients with LEDVT after gynecological pelvic surgery and the patients without LEDVT after gynecological pelvic surgery, control group （P 〉 0.05） . After 24 hours, FIB concentration and D - dimer level in the patients with LEDVT after gynecological pelvic surgery were statistically significantly higher than those in the patients without LEDVT after gynecological pelvic surgery and control group （P 〈 0.01 ） , but there was no statistically significant difference in the levels of PT, APTT and TT （ P 〉 0. 05 ） . After anticoagulant therapy, thrombolytic therapy, and anti - inflammatory therapy, all the patients were cured, no complications occurred. After recovery, there was no statistically significant difference in PT, APTT, TT, FIB, and D - dimer levels between the patients after gynecological pelvic surgery and control group （ P 〉 0. 05 ） . Conclusion： Coagulation function detection, especially FIB and D - dimer detection, has important effect for laboratory examination of patients with LEDVT after gynecological pelvic surgery, which can be used for early prediction of gynecological pelvic surgery combined with LEDVT, and it has a certain directive function for treatment and degree of recovery of patients with LEDVT after gynecological pelvic surgery.
出处
《中国妇幼保健》
CAS
北大核心
2012年第31期4875-4878,共4页
Maternal and Child Health Care of China
关键词
手术后并发症
下肢深静脉血栓
凝血功能
治疗和预防
Postoperative complication
Lower extremity deep venous thrombosis
Coagulation function
Treatment and prevention
