直肠癌手术前后血液流变学变化的研究

Study of hemorheology changes pre-and post-operation in patients with rectal cancer

目的研究直肠癌患者手术前后血液流变学的改变特点。方法选择直肠癌患者67例为试验组,同期健康人员60例为对照组,测定对照组和实验组术前、术后第1天、术后第4天、术后1周、术后2周、术后1个月、术后2个月的血液流变学指标。结果直肠癌患者的全血黏度、全血还原黏度、血浆黏度、血沉方程K值、红细胞刚性指数、红细胞聚集指数、纤维蛋白原高于对照组,患者术后的血液黏度较术前增加,根治术患者在术后2周恢复到术前水平,术后1月恢复到正常人水平,而姑息性手术的患者血液黏度在术后2周恢复到术前水平并持续稳定在这一水平。结论直肠癌患者存在血液流变学的异常,术后改善循环治疗对于血栓形成、肿瘤转移的预防都有重要意义,动态检测血液流变学指标有助于判断预后。

Objective To investigate the changes of hemorheology pre - and post - operation in patients with rectal cancer. Methods 67 patients with rectal cancer and 60 healthy individuals as eontrol group were invited to participate, hemorheologieal parameters of healthy individuals and patients were detected preoperatively, on the 1st day, 4th day, 1st week, 2nd week, 1 st month and 2nd month postoperatively. Results Patients with rectal cancer showed hyperviseosity, which presented with the increase of blood viscosity, blood reduced viscosity, plasma viscosity, value of erythrocyte sedimentation rate equation, erythrocyte rigidity index, erythrocyte aggregation index and fibrinogen. Postoperative blood viscosity level was higher than preoperative blood viscosity. Hemorheological parameters in the patients with radical operation returned to preoperative level 2 weeks and to normal level I month after operation, while that in the patients with palliative operation returned to preoperative level 2 weeks after operation and were continuously elevated. Conclusion Abnormality in hemorheology occurs in rectal cancer patients, and improving circulation postoperatively offers benefits to prevent thrombosis and metastasis for the patients, and dynamic detection of hemorheological parameters contributes to judge prognosis.