腹腔镜全子宫切除术对血小板参数及血栓蛋白的影响

The effect of laparoscopic hysterectomy on the parameters of platelet and thrombomodulin

目的:观察妇科腹腔镜手术对患者血小板参数及血栓蛋白的影响,了解腹腔镜手术是否存在深静脉血栓的高危因素。方法:选择腹腔镜及开腹全子宫切除术各19例患者,于术前及手术结束时抽静脉血分别检查血小板数量(plateletcount,PLT)、平均血小板体积(mean platelet volume,MPV)、血小板分布宽度(platelet distribution width,PDW)及血栓蛋白(thrombomodulin,TM),观察在CO2气腹下腹腔镜手术及开腹手术对上述指标的影响。结果:两组术后PLT均有不同程度下降,但无统计学意义(P>0.05),术后PDW,MPV,TM的变化较小,差异无统计学意义。结论:腹腔镜全子宫切除术对血小板参数及血栓蛋白产生的影响与开腹手术相比差异无统计学意义。

Objective ： To investigate the effect of laparoscopic hysterectomy on the parameters of platelet and thrombomodulin. Methods：Thirty-eight patients suffering from hysteromyoma were randomly assigned to undergo open （group A, n = 19） or laparoscopic hysterectomy （group B, n = 19） by the same surgical and anaesthetic team. Blood samples were taken preoperatively and at the end of the procedure. The following parameters were measured and compared within each group and between groups： platelet count（PLT）, mean platelet volume （ MPV）, platelet distribution width （ PDW ）, thrombomodulin （ TM ）. Results： After operation PLT decreased slightly hut not statistically significantly in both groups. The change of PDW, MPV and TM is not statistically significant. No patient from either group suffered thrombosis or abnormal bleeding as a postoperative complication. Conclusions：Laparoseopic procedures, as compared to open surgery, did not lead to increase of platelet parameters and thrombomodulin. It was not correct that laparoscopic hysterectomy should multiply the incidence of thrombosis.