开腹及腹腔镜下全子宫切除术后并发下肢深静脉血栓形成的临床分析

Clinical analysis the venous thrombophlebitis in leg of patients post laparoscopy and abdominal total hysterectomy

目的:比较分析开腹及腹腔镜下子宫全切除术后患者发生下肢深静脉血栓(DVT)的情况。方法:选择230例接受子宫全切除术的患者随机分为腹腔镜组120例和开腹组110例,分别检测术前24h、术后48h的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶凝固时间(TT)、纤维蛋白原(FIB)及血小板计数(PLT)值,比较两组患者上述指标变化及术后发生DVT的情况。结果:术后PT、APTT、TT、FIB及PLT值均有不同程度的改变,两组相应指标比较差异无统计学意义(P>0.05),腹腔镜组术后DVT发生率为5.0%,开腹组DVT发生率为9.09%,两者比较差异有统计学意义(P<0.05)。结论:开腹及腹腔镜下子宫全切除术后血液粘稠度均增加,两种术式对机体凝血功能的影响无明显不同,但腹腔镜手术后DVT的发生率低于开腹手术。

Objective： To analyze deep venous thrombophlebitis （DVT） in leg of patients post laparoscopy and abdominal total hysterectomy. Methods： 240 patients randomly selected for hysterectomy were divided into laparoscopic hysterectomy group （ LH ） （ n = 120） and abdominal hysterectomy group （AH） （ n = 110）, PT, APTT, TT, FIB, PLT were measured respectively 24 hours before operation and 48 hours after operation to observe the change of homeostasis parameters and the incidence of DVT after different hysterectomy operations. Results： PT, APTT, TT, FIB, PLT were changed after operation, but there were no significant differences between LH and AH group （ P 〉 0. 05） . The incidence of DVT was 5. 0% in LH group and 9. 09% in AH group, there was significant differences （ P 〈 0. 05） Conclusion： Both the LH and AH group patient~ blood are in hypercoagulation state after the operation, there is no significant difference between LH and AH group, but the occurrence of DVT in LH group is lower in AH group.