摘要
[目的]研究微创与开放手术前后食管癌患者血小板与凝血-纤溶系统变化特点。[方法]患者分为微创组(72例)和开放组(50例)。回顾性研究行食管癌根治术患者的性别、年龄、病理分型、TNM分期和术前1 d及术后1 d微创组与开放组患者血小板及凝血-纤溶系统参数。[结果]微创组与开放组相比,两组性别、年龄与手术前后PT、APTT、Fib、TT、PLT、D-二聚体差异无统计学意义(P> 0. 05);微创组PT、APTT、TT较开放组明显降低,而Fib、PLT、D-二聚体明显升高(P <0. 05);食管癌患者Fib水平鳞癌较腺癌升高(P <0. 05);食管癌Ⅲ期较I～Ⅱ期D-二聚体、Fib升高明显,APTT缩短(P <0. 05),PT、TT、PLT差异无统计学意义(P> 0. 05)。[结论]食管癌微创手术术后存在凝血-纤溶系统功能障碍,临床上应加强检测,围手术期应积极采取预防措施。
〔Objective〕To study the changes of platelet count,coagulation profile-and fibrinolytic system in patients with esophageal cancer in both minimally invasive surgery and open surgery.〔Methods〕The enrolled patients were divided into two groups,a minimally invasive surgery group and an open surgery group,72cases and50cases respectively.The parameters of this study were platelet count,coagulation profile and fibrinolytic system.The two groups were retrospectively studied for gender,age,pathological type,TNM staging both one day before surgery versus one day after surgery.〔Results〕Compared with the open group,both gender and age of the minimally invasive group were not correlated with the changes of(PT,APTT,Fib,TT,PLT and D-dimer)before and after surgery(P>0.05).The(PT,APTT and TT)in the minimally invasive group were significantly lower than those in the open group while(Fib,PLT and D-dimer)were significantly increased(P>0.05).The level of Fibrin in esophageal cancer patients was higher in squamous cell carcinoma type than that in adenocarcinoma type(P<0.05).Patients with stage III esophageal cancer had a significantly higher D-dimer level than that of stage I or II,Fibrin was increased and APTT was shortened(P>0.05).There was no significant difference in(PT,TT and PLT)(P>0.05).〔Conclusion〕There is a clotting-fibrinolytic system dysfunction after minimally invasive surgery for esophageal cancer.The clinical examination should be thorough and preventive measures should be followed cautiously during the perioperative period of this procedure.
作者
刘亚龙
刘东亚
安小康
张国瑜
师丙帅
郑先杰
张双林
LIU Yalong;LIU Yadong;AN Xiaokang;ZHANG Guoyu;SHI Bingshuai;ZHENG Xianjie;ZHANG Shuanglin(Department of Cardiothoracic Surgery,The First Affiliated Hospital of Henan University,Kaifeng 475000,China)
出处
《河南大学学报（医学版）》
CAS
2018年第4期257-259,共3页
Journal of Henan University:Medical Science
基金
河南省科技攻关计划项目(201602162)
关键词
食管癌
微创手术
开放手术
凝血-纤溶系统
Esophageal cancer
minimally invasive surgery
open surgery
coagulation-fibrinolytic system
