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目的:探讨乳腺癌患者手术前后凝血纤溶功能及血小板参数的变化情况及其意义。方法:收取2014年2月至2016年2月间于我院进行手术的乳腺癌患者90例作为研究对象进行回顾性分析,对其手术前一天及手术后凝血纤溶功能及血小板参数进行比较,另选择同期于我院进行体检的35例健康女性作为对照。结果:乳腺癌组手术前凝血纤溶功能各指标均显著高于对照组,手术后纤维蛋白原(FIB)、D-二聚体(D-D)均较术前明显升高,凝血酶原时间(PT)、活化部分凝血酶时间(APTT)明显降低,差异有统计学意义(P<0.05)。乳腺癌组手术前血小板参数均显著高于对照组,手术后血小板压积(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW)均较术前明显升高,差异有统计学意义(P<0.05)。肿瘤分期为Ⅰ~Ⅱ期的患者PT、APTT、FIB及D-D变化幅度均小于Ⅲ期患者;无淋巴结转移的患者TT、APTT变化幅度小于有淋巴结转移的患者;HER-2受体阴性患者D-D变化幅度小于HER-2受体阳性患者,差异有统计学意义(P<0.05)。肿瘤分期为Ⅰ~Ⅱ期的患者血小板计数(PLT)及MPV变化幅度小于Ⅲ期患者;HER-2受体阴性患者PLT及MPV变化幅度小于HER-2受体阳性患者,差异有统计学意义(P<0.05)。结论:乳腺癌患者凝血纤溶功能及血小板参数均较健康女性有较大改变,且术后患者血液高凝状态更加明显,机体存在更高的血栓风险,应加强围手术期管理。
Objective: To investigate the changes of coagulation and fibrinolytic function and platelet parameters before and after breast cancer patients and its significance. Methods: Totally 90 breast cancer patients undergoing surgery in our hospital from February 2014 to February 2016 were retrospectively analyzed. The coagulation and fibrinolytic function and platelet parameters were compared on the day before surgery and after surgery. Another choose the same period in our hospital for medical examination of 35 healthy women as a control. Results: The indexes of coagulation and fibrinolytic function before operation in breast cancer group were significantly higher than those in the control group. The fibrinogen (FIB) and D-dimer (DD) in patients with breast cancer were significantly higher than those before operation, the prothrombin time PT) and activated partial thromboplastin time (APTT) decreased significantly (P <0.05). The preoperative platelet parameters in breast cancer group were significantly higher than those in control group. The postoperative PCT, MPV and PDW were significantly higher than those before operation (P < P <0.05). The changes of PT, APTT, FIB and DD in patients with stage Ⅰ ~ Ⅱ were less than those in stage Ⅲ. The changes of TT and APTT in patients without lymph node metastasis were less than those with lymph node metastasis. The changes of DD in patients with HER-2 receptor negative The magnitude was lower than that of HER-2 receptor positive patients, the difference was statistically significant (P <0.05). The platelet count (PLT) and the change of MPV in patients with stage Ⅰ-Ⅱ were less than those in stage Ⅲ. The changes of PLT and MPV in patients with HER-2 receptor-negative were less than that in patients with HER-2 receptor, the difference was statistically significant ( P <0.05). CONCLUSIONS: The coagulation and fibrinolytic function and platelet parameters of patients with breast cancer have more changes than healthy women, and the state of blood hypercoagulation is more obvious after operation. The body has a higher risk of thrombosis and the perioperative management should be strengthened.