二氧化碳气腹对血小板膜糖蛋白的影响

The effects of platelet membrane glycoprotein during pneumoperitoneum of carbon dioxide

目的探讨二氧化碳(CO2)气腹对血小板膜糖蛋白的影响。方法30例CO2气腹腹腔镜胆囊切除术病人(观察组),观察手术前后血小板常规检测、凝血三项及血小板膜糖蛋白的变化,并与30例同时期同年龄剖腹手术胆囊切除术病人(对照组)进行比较。结果观察组术后血小板平均体积(MPV)明显增加(P<0.05),纤维蛋白原(Fib)水平显著升高(P<0.05),激活部分凝血活酶时间(APTT)延长的程度明显低于对照组(P<0.05),血小板粘附分子(P-选择素)与凝血酶敏感蛋白(TSP)明显增高(P<0.01);对照组则无明显变化。结论CO2气腹可使血液处于高凝状态,对有血栓形成倾向的病人,应采取抗凝措施,防止血栓栓塞并发症。

Objective To investigate the effects of platelet membrane glycoprotein during laparoscopic cholecystectomy under pneumoperitoneum with carbon dioxide （CO2）. Methods Thirty patients scheduled for selective laparoscopic cholecystectomy were studied（experiment group）,and the changes of platelet aggregation test and platelet membrane glycoprotein were assessed pre and postoperatively with flow cytometry,which were compared with those in patients undergoing open cholecystectomy （control group）. Results MPV,Fib and the percentage of activated P-selectin and thrombospondin（TSP） of platelet membrane glycoprotein were significanly increased in experiment group than those in control group （P〈0, 05）. APTT in experiment group was less obvious than that in control group. No significant changes in control group were found, Conclusion Blood hypercoagulability exists duing CO2 pneumoperitoneum, therefore, anticoagulation measures should be taken in patients with a tendendency to thromboemboliom.