腹腔镜胃癌手术与开腹手术对患者凝血功能的影响

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目的观察腹腔镜胃癌手术与开腹手术对患者凝血功能的影响。方法依据手术方式,将患者分为开腹手术与腔镜手术组,采用多普勒检测患者股静脉直径、平均血流速度与平均血流量;检测患者术前和术后凝血酶原国际标准化值(INR)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体以及纤维蛋白原(FIB)水平。结果与手术前相比,开腹手术组与腔镜手术组患者术后凝血酶原时间均显著延长(P﹤0.05),D-二聚体及纤维蛋白原含量显著增高,且以腔镜手术组患者更为明显(P﹤0.05);与开腹手术组相比,腔镜手术组患者术中股动脉直径显著增粗,平均血流速度与平均血流量均显著降低(P﹤0.05)。结论腹腔镜胃癌手术可导致患者处于高凝状态,可能发生血栓性疾病。 Objective To observe the influence of laparoscopic gastric surgery and laparotomy on coagulation function in patients. Methods According to the surgical method, the patients were divided into laparotomy group and endoscopic surgery group. The diameters of femoral vein, mean blood flow velocity and mean blood flow were measured by Doppler. The pre-and post-operative international standardized values ​​of prothrombin (INR), prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer and fibrinogen (FIB) levels. Results Compared with those before operation, the prothrombin time was significantly prolonged in patients undergoing laparotomy and endoscopic surgery (P <0.05), and the contents of D-dimer and fibrinogen were significantly increased. (P <0.05). Compared with the open surgery group, the diameter of intraoperative femoral artery in the operation group was significantly thicker, and the average blood flow velocity and mean blood flow were significantly decreased (P <0.05). Conclusion Laparoscopic gastric cancer surgery can lead to patients in hypercoagulable state, thrombotic disease may occur.
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