摘要
目的探讨腹腔镜与开腹手术对直肠癌患者凝血功能的的影响。方法 2015年6月~2016年6月间我科收治的80例直肠癌手术患者,38例行腹腔镜手术(腹腔镜组),42例行开腹手术(开腹组),检测手术前、后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)及血小板(PLT)的含量,并进行比较。结果两组PT及APTT术后与术前比较差异无统计学意义(P>0.05);PLT两组术后1 h及术后24 h较术前降低(P<0.05);两组术后1 h,FIB与术前相比差异无统计学意义(P>0.05),术后24 h两组均升高(P<0.05),组间差异无统计学意义(P>0.05)。两组D-D术后较术前均显著升高(P<0.05),且两组间差异有统计学意义(P<0.05)。结论腹腔镜直肠癌手术及开腹手术均可使患者血液呈高凝状态,易导致术后发生深静脉血栓的危险,且腹腔镜手术对凝血功能的影响更大,因此,应在围术期积极采取预防措施。
Objective To investigate the influence of laparoscopic surgery and laparotomy on coagulation function in patients with rectal cancer.Methods A total of 80 patients with rectal cancer admitted to our department from June2015 to June 2016 were selected.38 cases among them underwent laparoscopic surgery（laparoscopic group） and 42 patients underwent laparotomy（laparotomy group）.The prothrombin time（PT）,activated partial thromboplastin time（APTT）,fibrinogen（FIB）,D-dimer（D-D） and platelet（PLT） before and after surgery were measured and compared.Results There were no significant differences in PT and APTT before and after operation between the two groups（P〈0.05）.PLT in two groups at 1 hour and 24 hours after operation decreased compared with preoperative（P〈0.05）.There was no significant difference in FIB of two groups before operation compared with 1 hour after operation（P〉0.05）.FIB in both groups at24 h after operation increased compared with preoperative（P〈0.05）,and there was no significant difference between the two groups（P〉0.05）.D-D of two groups after operation were significantly higher than preoperative,and there was significant difference between the two groups（P〈0.05）.Conclusion Laparoscopic rectal cancer surgery and laparotomy both can make the patient＇s blood hypercoagulable,easily leading to the risk of postoperative deep vein thrombosis.Laparoscopic surgery has a greater impact on blood coagulation,and preventive measures should be actively taken during perioperative period.
出处
《中国现代医生》
2017年第1期15-17,29,共4页
China Modern Doctor
基金
浙江省温州市科技计划项目(Y20150236)
浙江省医药卫生科研基金项目(2017KY622)
关键词
腹腔镜手术
开腹手术
直肠癌
凝血功能
深静脉血栓形成
Laparoscopic surgery
Laparotomy
Rectal cancer
Coagulation function
Deep vein thrombosis
