围手术期食管癌患者血浆D-dimer的变化规律

Study of perioperative plasma D-dimer levels in patients with esophageal cancer

目的探讨围手术期食管癌患者血浆D-dimer水平的变化规律,评估发生血栓的风险。方法随机选取行手术治疗的29例食管癌患者为癌症组,同期开胸的12例良性病变患者为对照组,测定两组患者术前、术后3d、术后9d的血浆D-dimer水平,与其病理学特征及手术方式进行统计学分析。结果术后D-dimer在对照组(P<0.001)和癌症组(P<0.001)中均升高,但在癌症组中升高趋势明显(P<0.001)。癌症组中,血浆D-dimer在术后3d较术前升高显著,在术后9d升高趋于平缓。围手术期食管癌患者D-dimer水平改变与病理类型(P=0.64)、病理分级(P=0.84)、TNM分期(P=0.52)、手术方式(P=0.83)均无关。结论食管癌患者术后血浆D-dimer变化明显,术后可能并发血栓的风险也较高。

Objective To investigate the developmental changes of plasma D-dimer in esophageal cancer patients during the perioperative stage to evaluate the risk of embolism. Methods Plasma D-dimer level was measured in 29 untreated esophageal cancer patients(cancer group) and 12 patients with benign diseases(control group) before and after surgery(pre-operation,3rd day post-operation and 9th day post-operation).Plasma D-dimer level,clinicopathological findings and the type of surgery were evaluated. Results Plasma D-dimer level was increased in cancer and control groups after surgery(both P<0.001,respectively),and significantly higher in cancer group(P<0.001).In cancer group,plasma D-dimer level increased significantly in the first period(before surgery to 3 days after surgery),and increased mildly in the second period(3 to 9 days after surgery).However,the increased plasma D-dimer level was not related to histological type(P=0.64),histological differentiation(P=0.84),TNM stage(P=0.52),or the type of surgery(P=0.83). Conclusion Plasma D-dimer level is significantly increased in esophageal cancer patients after surgery,and the risk of developing embolism is higher in these patients.