高海拔地区腹腔镜胆囊切除术对血液系统的影响

Studying the Influence of Laparoscopic Cholecystectomy on Hematological System at High Altitude Area

目的:比较高海拔地区(>3000m,PO2<75%)开腹及腹腔镜胆囊切除术对血液系统的影响。方法:在高海拔地区接受胆囊切除术的163例患者按患者意愿分为开腹组78例和腹腔镜组85例,分别检测术前24h、术后24h的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)及血小板计数(PLT),比较两组患者术后深静脉血栓形成(DVT)发生的情况。结果:术后PT、APTT、TT、FIB及PLT值均有不同程度的改变,与术前比较差异有统计学意义(P<0.05)。两组相应指标比较差异无统计学意义(P>0.05)。开腹组和腹腔镜组术后各有DVT1例,DVT发生率分别为1.28%和1.18%,两者比较差异无统计学意义(P>0.05)。结论:高海拔地区开腹及腹腔镜胆囊切除术后均呈高凝状态,两种术式对机体凝血功能的影响无差异,术后DVT的发生率无差异。

Objective： To compare tbe influence of abdominal choleeystectomy and laparoscopic cholecysteetomy on hematological system at high altitude area. Methods： 163 cases of patients at high altitude area were randomly selected and divided into two groups, 78 cases for abdominal eholecystectomy and 85 cases for laparoscopic choleeystectomy. Indexes of prothrombin time （PT）, activated partial thromboplastin time（APTT）, thrombin time （TT）, fibrinogen （FIB） and platelet （PLT） were determined, 24 hours before and after operation respectively. The postoperative incidence of deep venous thrombosis （DVT） was observed. Results： Values of all the indexes changed significantly after operation （P 〈 0.05）, but there had no significant difference between these two groups （ P 〉 0.05）. In each group, one case of DVT was observed, with an incidence of 1.28% in AC and 1.18% in LC group, and there had no significant difference（ P 〉 0.05 ）. Conclusion： Both of the two operations at high altitude area can induce blood into hypereoagalabale state. No significant different influence on blood dotting function and incidence of DVT was observed between AC and LC group.