摘要
目的:观察血塞通注射液对腹腔镜胃癌手术患者凝血功能的影响,并探讨其可能机制。方法:将腹腔镜胃癌手术患者50例随机分为对照组和血塞通组(预防组),每组25例。对照组术后予常规抗感染和补液治疗,预防组在抗感染和补液治疗基础上于术后第1天起给予血塞通注射液400mg加5%葡萄糖注射液250mL,静脉滴注,1次/d,连续给药6d。于术前、术后即刻及术后3、5、7d采用凝固法检测患者凝血酶原时间(prothrombin ti me,PT)、活化部分凝血活酶时间(activated partial thromboplastin ti me,APTT)和纤维蛋白原(fibrinogen,FIB),采用国际标准化比值(international normalized ratio,INR)法计算凝血酶原INR,采用酶联免疫吸附双抗体夹心法定量测定血浆D-二聚体(D-di mer,D-D)含量,并于术后第7天运用深静脉造影观察两组术后下肢深静脉血栓的发生情况。结果:术前两组患者PT、APTT、INR、FIB和D-D比较,差异无统计学意义,具有可比性;术后两组患者APTT和INR均无明显变化。术后3d,两组患者PT均缩短(P<0.05),但两组比较,差异无统计学意义;随着术后时间的延长,对照组PT进一步缩短(P<0.05),而预防组变化不明显,与对照组比较,差异有统计学意义(P<0.05)。术后即刻两组患者FIB和D-D均升高(P<0.05),两组间差异无统计学意义。随着术后时间的延长,对照组FIB和D-D逐步升高(P<0.05);而预防组术后3d D-D亦升高(P<0.05),但与术后即刻比较,差异无统计学意义,其术后5、7d D-D水平则持续下降(P<0.05)。术后第7天预防组下肢深静脉血栓发生率显著低于对照组。结论:腹腔镜胃癌手术可使患者血液呈高凝状态,增加术后血栓发生的风险,而血塞通注射液可有效改善腹腔镜胃癌手术所致血液高凝状态,降低术后血栓发生的风险。
Objective： To study the effects of Xuesaitong Injection, an extract from a Chinese herbal medicine, on coagulation function of gastric cancer patients undergoing laparoscopic surgery. Methods： Fifty patients undergoing laparoscopic surgery for gastric cancer were randomly divided into control group and Xuesaitong group, with 25 patients in each group. Conventional anti-infection and transfusion treatment was given to the patients in the control group, and intravenous drip infusion of 400 mg Xuesaitong Injection added into 250 mL 5% glucose injection was administered once daily to the patients in the Xuesaitong group for 6 days from the first day after laparoscopic operation besides the conventional anti- infection and transfusion treatment. The values of prothrombin time （PT）, activated partial thromboplastin time （APTT）, fibrinogen （FIB） and international normalized ratio （INR） were detected by using blood coagulation method, and the values of D-dimer （D-D） before operation, instantly and 3, 5, 7 days after operation were detected by using enzyme-linked immunosorbent assay in the two groups. Furthermore, the development of deep vein thrombosis on the day 7 after operation was observed by vein angiography. Results： There were no significant differences in the values of PT, APTT, INR, FIB and D-D between the two groups before operation, and there were no significant changes in APTT and INR after operation in the two groups. The values of PT decreased in the two groups on day 3 after operation, while there was no significant difference between the two groups. The value of PT in the control group decreased gradually with the extension of postoperation time （P〈0.05）, while the PT value in the Xuesaitong group did not change significantly, and there was significant difference between the two groups （P〈0.05）. The values of FIB and D-D increased instantly after operation in the two groups as compared with those before operation （P〈0. 05）, while there was no significant differe
出处
《中西医结合学报》
CAS
2009年第6期514-517,共4页
Journal of Chinese Integrative Medicine
关键词
腹腔镜外科手术
胃癌
血塞通注射剂
凝血因子
随机对照试验
laparoscopic surgical procedures
gastric cancer
Xuesaitong Injection
coagulation factors
randomized controlled trial
